不同浓度罗哌卡因联合舒芬太尼用于PIEB分娩镇痛的效果研究  

Effect of different concentrations of ropivacaine combine with sufentanil on labor analgesia in PIEB

作　　者：窦雅丽 海克蓉[2] 杨付明[1] 张晓[1] 闻云霞[1] 朱宁焘 DOU Yali;HAI Kerong;YANG Fuming;ZHANG Xiao;WEN Yunxia;ZHU Ningtao(Department of Anesthesiology,People's Hospital of Guyuan,Guyuan 756000,China;Department of Anesthesiology,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏固原市人民医院麻醉科,宁夏固原756000 [2]宁夏回族自治区人民医院麻醉科,宁夏银川750000

出　　处：《宁夏医学杂志》2023年第8期717-719,共3页Ningxia Medical Journal

基　　金：宁夏回族自治区卫生健康委重点科研课题(2019NW089)。

摘　　要：目的分析罗哌卡因联合舒芬太尼浓度配伍差异对初产妇自控镇痛和不良反应的影响。方法选取180例足月行硬膜外麻醉分娩镇痛的初产妇,并将其随机分成3组:A组(0.075%罗哌卡因)、B组(0.1%罗哌卡因)、C组(0.15%罗哌卡因),每组均联合0.4μg/mL舒芬太尼,各组硬膜外给予首剂量8~10 mL,30 min后连接硬膜外镇痛泵开始模式镇痛。比较各组初产妇感觉阻滞开始时间、镇痛维持时间、分娩期疼痛VAS评分、产程持续时长、Apgar评分、镇痛不良反应总发生率。结果3组改良Bromage评分均为0级,均未出现运动阻滞。A组感觉阻滞开始时间较B、C组晚(P<0.05),B、C组镇痛维持时间明显较A组更长(P<0.05);B、C组阻滞15 min、阻滞30 min、阻滞1 h、侧切时和手术结束时疼痛VAS评分均较A组低(P<0.05);C组第1产程持续时间较A、B组长(P<0.05),不良反应总发生率较A、B组高(P<0.05);而A组第2产程较B、C两组长(P<0.05)。结论0.1%罗哌卡因联合0.4μg/mL舒芬太尼对初产妇行PIEB分娩镇痛可提供较好镇痛效果,同时减少不良反应发生,更适宜推广应用。ObjectiveTo explore the effect of the different concentrations of ropivacaine combined with sufentanil on the efficacy and adverse reactions of self-controlled analgesia in primiparas.Methods 180 full-term primiparas undergoing epidural anesthesia for labor analgesia were randomly divided into three groups:group A(0.075%ropivacaine),group B(0.1%ropivacaine)and group C(0.15%ropivacaine).Each group was compounded with 0.4μg/mL sufentanil.After 30 minutes,an epidural analgesia pump was connected to begin PIEB mode analgesia.The onset time of sensory blockade,duration of analgesia,VAS score during labor,duration of labor,Apgar score,and the total incidence of analgesic adverse reaction were compared among the primiparas in each group.Results Modified Bromage scores in three groups were grade 0 and motor block was not observed.The onset time of sensory block in group A was slower than that in groups B and C(P<0.05),and the duration of analgesic maintenance in groups B and C was significantly longer than that in group A(P<0.05).The VAS scores at 15 minutes,30 minutes,1 hour after onset of sensory block,lateral incision and the end of surgery in groups B and C were lower than those in group A(P<0.05).The duration of the first stage of labor was longer and the overall incidence of adverse reactions in group C were higher than those in groups A and B(P<0.05).However,the duration of the second stage of labor in group A was longer than that in groups B and C(P<0.05).Conclusion 0.1%ropivacaine combined with 0.4μg/mL sufentanil can provide better analgesia with PIEB in primiparas and reduce the occurrence of adverse reactions,which is more suitable for promotion and application.

关 键 词：舒芬太尼 罗哌卡因 硬膜外分娩镇痛 程控硬膜外间歇脉冲输注 

分 类 号：R714.3[医药卫生—妇产科学]