纳布啡复合罗哌卡因对产妇分娩的镇痛效果  

Analgesic effect of nalbuphine combined with ropivacaine for parturients during delivery

作　　者：陶永峰 李静 王艳玲 TAO Yong-Feng;LI Jing;WANG Yan-Ling(Department of Anesthesiology,Yinchuan Municipal Maternal and Child Health Care Hospital,Yinchuan,Ningxia 750001,China)

机构地区：[1]银川市妇幼保健院麻醉科,宁夏银川750001

出　　处：《中国妇幼保健》2022年第16期2931-2935,共5页Maternal and Child Health Care of China

基　　金：宁夏回族自治区科技支撑计划项目(2013ZYS134)。

摘　　要：目的 分析纳布啡复合罗哌卡因对产妇分娩的镇痛效果。方法 选取2020年1月—2021年1月银川市妇幼保健院收治的120例产妇为研究对象,采用随机数字表分为对照组(60例)和研究组(60例)。对照组给予枸橼酸舒芬太尼注射液复合盐酸罗哌卡因注射液行患者自控硬膜外镇痛(PCEA),研究组给予盐酸纳布啡注射液复合盐酸罗哌卡因注射液行PCEA。比较两组产妇术中、术后情况,罗哌卡因消耗量,镇痛相关指标,产后日常活动疼痛程度,新生儿娩出后5 min的脐动脉血气指标。结果 研究组每小时罗哌卡因消耗量、镇痛起效时间及首次PCEA时间分别为[(9.39±2.23)mg/L、(14.12±6.57)min及(62.21±5.67)min],每小时罗哌卡因消耗量高于对照组[(8.21±2.15)mg/L],镇痛起效时间、首次PCEA时间均短于对照组[(17.34±9.61)min和(131.42±6.78)min],差异均有统计学意义(t=2.951,P<0.05;t=2.143,P<0.05;t=60.656,P<0.05)。研究组睡眠痛、排尿痛、坐痛视觉模拟评分法(VAS)评分为0分的患者占比分别为30.00%、50.00%及68.33%,均高于对照组的8.33%、16.67%及41.67%(均P<0.05)。新生儿娩出后5 min,两组新生儿脐动脉乳酸(Lac)、pH值及二氧化碳分压(PCO_(2))比较,差异均无统计学意义(均P>0.05)。结论 舒芬太尼复合罗哌卡因与纳布啡复合罗哌卡因均对产妇术中、术后情况和新生儿脐动脉血气无明显影响,其中纳布啡复合罗哌卡因分娩镇痛起效较快,可明显减轻产妇睡眠痛、排尿痛及坐痛,但罗哌卡因消耗量较高。Objective To analyze the analgesic effect of nalbuphine combined with ropivacaine for parturients during delivery.Methods From January 2020 to January 2021,120 parturients treated in Yinchuan Municipal Maternal and Child Health Care Hospital were selected and divided into control group and study group according to random number table,60 parturients in each group.The parturients in control group were given sufentanil citrate injection combined with ropivacaine hydrochloride injection for patient-controlled epidural analgesia(PCEA),the parturients in study group were given nalbuphine hydrochloride injection combined with ropivacaine hydrochloride injection for PCEA.The intraoperative and postoperative situations,doses of ropivacaine,analgesic related indicators,pain levels of daily activities after delivery,neonatal umbilical arterial blood gas indexes at 5 minutes after birth in the two groups were compared.Results Ropivacaine dose per hour,the onset time of analgesia,and the initial PCEA time in study group were(9.39±2.23) mg/L,(14.12±6.57) minutes,and(62.21±5.67) minutes,respectively,ropivacaine dose per hour in study group was higher than that in control group [(8.21±2.15) mg/L],the onset time of analgesia and the initial PCEA time in study group were shorter than those in control group [(17.34±9.61) minutes and(131.42±6.78) minutes,respectively],there were statistically significant differences(t=2.951,P0.05).Conclusion Both sufentanil combined with ropivacaine and nalbuphine combined with ropivacaine has no significant impact on intraoperative and postoperative situations,neonatal umbilical arterial blood gas indexes,the onset of nalbuphine combined with ropivacaine is fast,which can significantly relieve hypnalgia,urodynia,and sitting pain of parturients,but ropivacaine dose is high.

关 键 词：产妇 分娩 纳布啡 罗哌卡因 镇痛效果 

分 类 号：R714.3[医药卫生—妇产科学]