低剂量罗哌卡因联合布托啡诺硬膜外麻醉对分娩镇痛效果和分娩结局的影响  

Effect of Low Dose Ropivacaine and Butorphanol Epidural Anesthesia on Labor Analgesia and Labor Outcome

作　　者：汪艳萍[1] 许宜珍 袁应川[1] 古丽·亚科夫 陈政文[1] WANG Yanping;XU Yizhen;YUAN Yingchuan;Guli·Yakefu;CHEN Zhengwen(The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China;不详)

机构地区：[1]新疆医科大学第二附属医院,新疆乌鲁木齐830063

出　　处：《中外医学研究》2023年第26期25-28,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨低剂量罗哌卡因联合布托啡诺硬膜外麻醉对围生期孕妇分娩镇痛效果及分娩结局的影响。方法:选择2020年1月—2022年12月新疆医科大学第二附属医院收治的160例单胎头位孕足月初产妇为研究对象,按照分娩过程中使用硬膜外麻醉药物剂量的不同分为正常剂量组(0.25%罗哌卡因联合1.0%布托啡诺)与低剂量组(0.125%罗哌卡因联合0.5%布托啡诺),各80例。比较两组疼痛开始缓解时间、疼痛完全缓解持续时间、视觉疼痛模拟评分法(VAS)评分、改良Bromage评分及新生儿Apgar评分。比较两组阴道顺产率、器械分娩率、剖宫产率、胎儿窘迫发生率及新生儿窒息发生率。结果:两组疼痛开始缓解时间、疼痛完全缓解持续时间、VAS评分比较,差异无统计学意义(P>0.05)。低剂量组改良Bromage评分低于正常剂量组,新生儿Apgar评分高于正常剂量组,差异有统计学意义(P<0.05)。低剂量组阴道顺产率高于正常剂量组,器械分娩率、剖宫产率、胎儿窘迫发生率及新生儿窒息发生率均低于正常剂量组,差异有统计学意义(P<0.05)。结论:围生期孕妇应用低剂量的罗哌卡因联合布托啡诺硬膜外麻醉能有效减轻双下肢运动神经阻滞程度,降低器械分娩率,显著改善分娩结局。Objective:To investigate the effect of low dose Ropivacaine combined with Butorphanol epidural anesthesia on labor analgesia and labor outcome of perinatal pregnant women.Method:A total of 160 cases of single cephalic full-term primipara treated in the Second Affiliated Hospital of Xinjiang Medical University from January 2020 to December 2022 were selected as the study objects.They were divided into normal dose group(0.25%Ropivacaine combined with 1.0%Butorphanol)and low dose group(0.125%Ropivacaine combined with 0.5%Butorphanol)according to the different doses of epidural anesthesia during delivery,80 cases in each group.The time of pain relief,visual pain analogue scale(VAS)score,modified Bromage score and neonatal Apgar score were compared between the two groups.The rate of vaginal delivery,instrumental delivery,cesarean section,fetal distress and neonatal asphyxia were compared between the two groups.Result:There were no significant differences in the time of pain relief,duration of complete pain relief and VAS score between the two groups(P>0.05).The modified Bromage score in low dose group was lower than that in normal dose group,and the neonatal Apgar score was higher than that in normal dose group,the differences were statistically significantal(P<0.05).The vaginal delivery rate of low dose group was higher than that of normal dose group,and the incidence of instrumental delivery,cesarean section,fetal distress and neonatal asphyxia were lower than those of normal dose group,the differences were statistically significant(P<0.05).Conclusion:Perinatal pregnant women with low dose of Ropivacaine combined with Butorphanol epidural anesthesia can effectively reduce the degree of lower extremity motor nerve block,reduce the rate of instrumental delivery,and significantly improve the delivery outcome.

关 键 词：硬膜外麻醉 器械分娩 胎儿预后 罗哌卡因 布托啡诺 

分 类 号：R714.3[医药卫生—妇产科学]