罗哌卡因复合舒芬太尼连续硬膜外麻醉对产妇应激反应、母婴结局的影响研究  

Influence of Continuous Epidural Anesthesia with Ropivacaine and Sufentanil on Maternal Stress Response and Maternal and Neonatal Outcomes

作　　者：谢云 陶瑞雪[1] 杨静[1] Xie Yun;Tao Rui-xue;Yang Jing(Department of Obstetrics and Gynecology,Hefei First People’s Hospital,Hefei 230061,China)

机构地区：[1]合肥市第一人民医院妇产科,合肥230061

出　　处：《湖南师范大学学报（医学版）》2021年第2期83-86,共4页Journal of Hunan Normal University(Medical Sciences)

基　　金：合肥市卫计委2018年应用医学研究项目(NO.hwk2018zd002)。

摘　　要：目的:观察罗哌卡因复合舒芬太尼连续硬膜外麻醉对产妇应激反应、母婴结局的影响。方法:选取我院85例产妇,以数字表法随机分为2组,均采取连续硬膜外麻醉方式,对照组使用罗哌卡因,实验组使用罗哌卡因复合舒芬太尼,比较2组镇痛指标(镇痛起效时间、维持时间与完全阻滞时间)、产程中疼痛(NRS)评分、分娩方式及新生儿结局,检测镇痛前与分娩后应激反应指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]。结果:实验组镇痛起效时间以及完全阻滞时间均明显短于对照组,维持时间明显长于对照组;2组分娩前与第二产程NRS评分比较无显著差异;实验组第一产程NRS评分明显低于对照组;实验组分娩后SOD水平明显高于对照组,MDA明显低于对照组;实验组中转剖宫产率明显低于对照组;2组产后1min与5min新生儿Apgar评分比较无显著差异。结论:罗哌卡因复合舒芬太尼连续硬膜外麻醉可有效提高产妇麻醉镇痛效果,降低机体应激反应与第一产程疼痛,提高自然分娩率,并且不影响新生儿结局。Objective To observe the influence of continuous epidural anesthesia with ropivacaine and sufentanil on maternal stress response and maternal and neonatal outcomes.Methods Eighty-five parturients were selected and randomly divided into two groups.According to the drug used for continuous epidural anesthesia,parturients receiving ropivacaine were included in the control group,while those receiving ropivacaine and sufentanil were included in the experimental group.The analgesia indexes(onset time and duration of analgesia,complete block time),numeric rating scale(NRS)score in labor process,delivery mode and neonatal outcome were compared between the two groups.The stress response indexes[superoxide dismutase(SOD),malondialdehyde(MDA)]were detected before and after analgesia.Results The onset time of analgesia and complete block time in the experimental group were significantly shorter than those in the control group,and the duration was significantly longer than that in the control group.There was no significant difference in NRS score between the two groups before delivery and during the second stage of labor,but the NRS score of the experimental group during the first stage of labor was significantly lower than that of the control group.After delivery,the experimental group had significantly higher SOD level and significantly lower MDA level than the control group.The rate of conversion to cesarean section in the experimental group was significantly lower than that in the control group.No significant differences were found in 1min and 5min neonatal Apgar scores between the two groups.Conclusion Continuous epidural anesthesia with ropivacaine combined with sufentanil can effectively improve the analgesic effect,reduce stress response,alleviate pain during the first stage of labor,and improve the natural delivery rate,without influencing neonatal outcome.

关 键 词：罗哌卡因 舒芬太尼 硬膜外麻醉 应激反应 母婴结局 

分 类 号：R714.3[医药卫生—妇产科学]