纳布啡联合罗哌卡因与单独用药在椎管内分娩镇痛的效果比较  

Comparison of Analgesic Effects of Nalbuphine Combined with Ropivacaine and Drug Alone in Spinal Canal Delivery

作　　者：任莹莹 刘定国 REN Ying-ying;LIU Ding-guo(Department of Anesthesia and Surgery,The Third People’s Hospital of Henan Province,Zhengzhou,Henan,450006,China)

机构地区：[1]河南省直第三人民医院麻醉手术部,河南郑州450006

出　　处：《黑龙江医学》2023年第2期150-153,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨纳布啡联合罗哌卡因实施椎管内分娩镇痛的效果及安全性。方法:选取2018年1月—2019年7月河南省直第三人民医院产科拟实施无痛分娩的150例孕妇作为研究对象,采用随机数表法分为研究组和对照组,每组各75例,研究组采用纳布啡联合罗哌卡因实施椎管内分娩镇痛,对照组采用罗哌卡因+舒芬太尼实施椎管内分娩镇痛;评估两组产妇不同时间点的视觉模拟疼痛量表(VAS)评分、Ramsay镇静评分、第一产程、第二产程、分娩前及胎儿娩出后即刻血清白细胞介素-6(IL-6)、皮质醇(Cor)、5-羟色胺(5-HT)、P物质(SP)及不良反应。结果:给药30 min、给药60 min及宫口全开后,研究组的VAS评分低于对照组,差异有统计学意义(F=5.591,P<0.05);研究组和对照组的第一产程时间、第二产程时间、第三产程时间比较,差异无统计学意义(t=0.569、-1.425、0.543,P>0.05);在胎儿娩出后即刻,研究组的血清IL-6、Cor、5-HT、SP水平均低于对照组,差异有统计学意义(t=-2.911、-3.857、-3.538、-7.494,P<0.05);研究组的不良反应发生率(6.67%)与对照组(14.67%)比较,差异无统计学意义(χ^(2)=2.519,P>0.05)。结论:纳布啡联合罗哌卡因实施椎管内分娩镇痛效果优于罗哌卡因+舒芬太尼,可有效减轻分娩疼痛,降低疼痛应激因子水平。Objective:To investigate the effect and safety of nalbuphine combined with ropivacaine in the analgesia of spinal canal delivery.Methods:150 cases of pregnant women who were to be implemented painless delivery in the hospital from January 2018 to July 2019 were selected as the study population and were divided into study and control groups using the random number table method,with 75 cases in each group.The study group used nalbuphine combined with ropivacaine for intradural labor analge⁃sia,and the control group used ropivacaine+sufentanil for intradural labor analgesia.Visual analogue pain scale(VAS)scores,Ram⁃say sedation scores,serum interleukin-6(IL-6),cortisol(Cor),5-hydroxytryptamine(5-HT),substance P(SP)and adverse effects were assessed in both groups at different time points.Results:The VAS scores of the study group were lower than those of the con⁃trol group after 30 min of administration,60 min of administration and full opening of the uterus,and the difference was statistical⁃ly significant(F=5.591,P<0.05).There was no statistically significant difference between the study and control groups in terms of time to first stage of labor,time to second stage of labor,and time to third stage of labor(t=0.569,-1.425,0.543,P>0.05).In the immediate post-delivery period,serum IL-6,Cor,5-HT,and SP levels were lower in the study group than in the control group,with statistically significant differences(t=-2.911,-3.857,-3.538,-7.494,P<0.05).The difference in the incidence of adverse re⁃actions in the study group(6.67%)compared with the control group(14.67%)was not statistically significant(χ^(2)=2.519,P>0.05).Conclusion:Nalbuphine combined with ropivacaine was more effective than ropivacaine+sufentanil for intraventricular labor anal⁃gesia,and was effective in reducing labor pain and pain stress factor levels.

关 键 词：纳布啡 罗哌卡因 椎管内分娩镇痛 安全性 

分 类 号：R657.4[医药卫生—外科学]