罗哌卡因联合舒芬太尼持续硬膜外镇痛在无痛分娩中的疗效及对母婴结局的影响  

Efficacy of Ropivacaine Combined with Sufentanil for Continuous Epidural Analgesia in Painless Delivery and its Effect on Maternal and Infant Outcomes

作　　者：马艳丽 MA Yanli(Department of Anesthesiology,Enliang Hospital,Taian County,Anshan 114100,China)

机构地区：[1]辽宁省鞍山市台安县恩良医院麻醉科,辽宁鞍山114100

出　　处：《中国医药指南》2021年第35期16-18,共3页Guide of China Medicine

摘　　要：目的研究探讨罗哌卡因联合舒芬太尼持续硬膜外镇痛在产妇阴道分娩中的临床疗效及其对母婴结局的影响。方法选择2017年1月至2019年6月在我院行阴道试产的209例产妇为研究对象,按照随机原则分成两组,对照组产妇104例,采用罗哌卡因持续硬膜外镇痛,观察组产妇105例,采用罗哌卡因联合舒芬太尼持续硬膜外镇痛。比较两组产妇的产程时间、镇痛效果、应激反应、阴道分娩成功率及产妇并发症的发生率,同时通过Apgar评分对新生儿情况进行比较。结果观察组产妇第一产程、第二产程、第三产程均短于对照组;观察组产妇镇痛效果优于对照组;观察组血糖、皮质醇及胰岛素增值/血糖增值低于对照组;观察组自然分娩、阴道助产及剖宫产分别为71.43%、3.81%、24.76%,对照组为38.46%、17.31%、44.23%;观察组产妇并发症发生率低于对照组,两组差异有统计学意义(P<0.05),两组新生儿Apgar评分无统计学意义(P>0.05)。结论罗哌卡因联合舒芬太尼持续硬膜外麻醉镇痛效果好、持续时间长,两药联用能减少药物用量,降低药物不良反应的发生,同时硬膜外用药能减轻药物对产妇神经系统和新生儿呼吸系统的不良影响,提高阴道分娩的安全性和成功率。Objective To study the clinical efficacy of ropivacaine combined with sufentanil continuous epidural analgesia in vaginal delivery of parturients and its influence on maternal and infant outcomes.Methods Two hundred and nine parturients who underwent vaginal trial delivery in our hospital from January 2017 to June 2019 were selected as the research objects.They were divided into two groups according to the principle of randomization.There were 104 parturients in the control group who were treated with ropivacaine for continuous epidural sedation.Pain,105 parturients in the observation group received continuous epidural analgesia with ropivacaine combined with sufentanil.The labor time,analgesic effect,stress response,successful rate of vaginal delivery and the incidence of maternal complications were compared between the two groups of parturients.At the same time,the newborns were compared by Apgar score.Results The first,second,and third stages of labor in the observation group were shorter than those in the control group;the observation group had better analgesic effects than the control group;the observation group's blood glucose,cortisol and insulin increments/blood glucose increments were lower than those of the control group;The observation group's natural delivery,vaginal delivery and cesarean section were 71.43%,3.81%,and 24.76%,respectively,and the control group were 38.46%,17.31%,44.23%;the observation group's maternal complications rate was lower than that of the control group,and there was a difference between the two groups There was statistical significance(P<0.05),and the Apgar scores of the two groups of newborns were not statistically significant(P>0.05).Conclusion Ropivacaine combined with sufentanil continuous epidural anesthesia has a good analgesic effect and a long duration.The combined use of the two drugs can reduce the drug dosage and reduce the occurrence of adverse drug reactions.At the same time,epidural medication can reduce the drug's effect on the parturient.The adverse effects of t

关 键 词：持续硬膜外镇痛 舒芬太尼 罗哌卡因 无痛分娩 

分 类 号：R614[医药卫生—麻醉学] R714[医药卫生—外科学]