小剂量罗哌卡因联合舒芬太尼腰硬联合麻醉在分娩镇痛中的应用探讨  

Discussion on the Application of Low-dose Ropivacaine Combined with Sufentanil Lumbar Hard Combined Anesthesia in Labor Analgesia

作　　者：谢月园 翁迪贵 郑艳庄 梁亚贵 XIE Yueyuan;WENG Digui;ZHENG Yanzhuang;LIANG Yagui(Department of Anesthesiology,Mindong Hospital,Ningde,Fujian Province,355000 China)

机构地区：[1]宁德市闽东医院麻醉科,福建宁德355000

出　　处：《中外医疗》2022年第33期118-122,共5页China & Foreign Medical Treatment

基　　金：宁德市科技计划项目(20160188)。

摘　　要：目的分析分娩镇痛过程中,灵活应用小剂量罗哌卡因联合舒芬太尼腰硬联合麻醉的作用效果。方法回顾性分析2019年1月-2020年4月宁德市闽东医院麻醉科收治的100例行分娩镇痛产妇的患者资料,根据不同麻醉方法分为对照组和研究组。两组用药配方均为0.08%罗哌卡因+0.4μg/mL舒芬太尼,在此基础上,对照组(n=50)给予硬膜外麻醉,研究组(n=50)给予腰硬联合麻醉。比较两组麻醉起效时间,分娩镇痛过程满意度和麻醉用药前后疼痛评分等。结果研究组分娩镇痛起效时间短于对照组,差异有统计学意义(t=28.729,P<0.05)。研究组分娩镇痛过程产妇满意度为98.00%,明显高于对照组的82.00%,差异有统计学意义(χ^(2)=7.111,P<0.05)。研究组干预后3、5、10 minVAS评分分别为(3.20±1.29)分、(2.30±1.12)分、(1.50±0.40)分,均低于对照组,差异有统计学意义(t=13.520、18.085、29.607,P<0.001)。研究组改良Bromage评分变化优于对照组,差异有统计学意义(P<0.05)。麻醉后,两组胎心监测中反应型、可疑型比例比较,差异有统计学意义(χ^(2)=-2.128,P=0.033)。结论在分娩过程中,小剂量罗哌卡因联合舒芬太尼腰硬联合麻醉,可以缩短分娩镇痛起效时间,提高产妇满意度和镇痛效果。但是由于起效快胎心短时间变化较大,应加强胎心监测。Objective To analyze the effect of flexible application of low-dose ropivacaine combined with sufentanil lumbar-hard combined anesthesia during labor analgesia.Methods The data of 100 maternal patients with labor analgesia admitted to the Department of Anesthesiology of Mindong Hospital in Ningde from January 2019 to April 2020 were retrospectively analyzed and divided into control group and study group according to different anesthesia methods.The drug formulation for both groups was 0.08%ropivacaine+0.4μg/mL sufentanil,based on which the control group(n=50)was given epidural anesthesia and the study group(n=50)was given combined lumbar and epidural anesthesia.Compare the onset time of anesthesia,satisfaction of labor analgesia process and pain score before and after anesthesia in the two groups.Results The onset time of labor analgesia in the study group was shorter than that in the control group,and the difference was statistically significant(t=28.729,P<0.05).The maternal satisfaction during labor analgesia was 98.00%in the study group,which was significantly higher than 82.00%in the control group,the difference was statistically significant(χ^(2)=7.111,P<0.05),3 min,5 min and 10 min after intervention,the visual analog pain scores of the study group were(3.20±1.29)points,(2.30±1.12)points and(1.50±0.40)points,respectively,which were lower than those of the control group,and the difference was statistically significant(t=13.520,18.085,29.607,P<0.001).The change of the modified Bromage score in the study group was better than that in the control group,and the difference was statistically significant(P<0.05).After anesthesia,the proportion of reactive type and suspicious type in fetal heart monitoring between the two groups were compared,and the difference was statistically significant(χ^(2)=-2.128,P=0.033).Conclusion During labor,low-dose ropivacaine combined with sufentanil combined lumbar and epidural anesthesia can shorten the onset time of labor analgesia,improve maternal satisfaction and analgesia e

关 键 词：小剂量罗哌卡因 舒芬太尼 腰硬麻醉 分娩镇痛 

分 类 号：R5[医药卫生—内科学]