初产妇无痛分娩中舒芬太尼结合罗哌卡因行腰-硬联合阻滞应用效果  

Application effect of sufentanil combined with ropivacaine used in the combined spinal-epidural block for painless labor of primiparas

作　　者：耿素娟 李娜 孙丽[1] GENG Sujuan;LI Na;SUN Li(Zhengzhou Seventh People's Hospital,Zhengzhou,Henan Province,450000)

机构地区：[1]河南省郑州市第七人民医院,450000

出　　处：《中国计划生育学杂志》2024年第12期2796-2800,共5页Chinese Journal of Family Planning

摘　　要：目的:探究舒芬太尼结合罗哌卡因行腰-硬联合阻滞在初产妇无痛分娩中的应用效果。方法:选择2021年8月-2023年8月本院行无痛分娩初产妇90例,随机数字表法分为对照组(罗哌卡因)和观察组(舒芬太尼结合罗哌卡因)各45例,两组均行腰-硬联合阻滞。比较两组镇痛前、产后5min时血清泌乳素(PRL)、脂联素(APN)、组织型纤溶酶原激活物(t-PA)水平,记录两组镇痛指标镇痛显效时间、首次硬膜外自控镇痛(PCEA)时间、镇痛持续时间、三段产程、分娩结局、麻醉不良反应。结果:产后5min时,两组血清PRL、APN、t-PA水平均较镇痛前升高且观察组PRL、APN水平均高于对照组,t-PA水平低于对照组(P<0.05);观察组镇痛显效时间(5.83±1.25min)早于对照组(12.39±3.08min),首次PCEA时间(86.01±9.11min)晚于对照组(49.83±7.26min),镇痛持续时间(313.24±70.67min)长于对照组(265.57±64.82min),三段产程时间均少于对照组(P<0.05);两组妊娠结局、麻醉不良反应无差异(P>0.05)。结论:舒芬太尼联合罗哌卡因可提升无痛分娩的镇痛效果,可控制机体纤溶功能,缩短产程时间,有利于初产妇分娩顺利及分娩后泌乳,对分娩结局、麻醉不良反应影响不显著。Objective:To explore the application effect of sufentanil combined with ropivacaine used in the combined spinal-epidural block for painless labor of primiparas.Methods:A total of 90 primiparas who wanted painless labor were selected and were divided into two groups(45 cases in each group)by the random number table method between August 2021 and August 2023.The primiparas in the control group were given ropivacaine in the combined lumbar-epidural block painless labor,and the primiparas in the observation group were given sufentanil combined with ropivacaine in the combined lumbar-epidural block for painless labor.The levels of the serum prolactin(PRL),adiponectin(APN)and tissue plasminogen activator(t-PA)of the primiparas before analgesia and at 5 min after labor were compared between the two groups.The analgesic indicators values and the analgesia effective time,the first time of patient-controlled epidural analgesia(PCEA)used,the duration of analgesia,the three stages of labor time,the delivery outcomes and the adverse reactions rate of anesthesia of the primiparas were compared between the two groups.Results:The levels of the serum PRL,APN and t-PA of the primiparas in the two groups at 5 min after delivery were significantly higher than those before analgesia,and the levels of PRL and APN of the primiparas in the observation group were significantly higher than those of the primiparas in the control group,but the t-PA level of the primiparas in the observation group was significantly lower(P<0.05).The effective time of analgesia(5.83±1.25 min)of the primiparas in the observation group was significantly shorter than that(12.39±3.08 min)of the primiparas in the control group,and the time of the first time of PCEA used(86.01±9.11 min)of the primiparas in the observation group was significantly later than that(49.83±7.26 min)of the primiparas in the control group.The duration of analgesia(313.24±70.67 min)of the primiparas in the observation group was significantly longer than that(265.57±64.82 min)of the pr

关 键 词：无痛分娩 初产妇 舒芬太尼 罗哌卡因 腰-硬联合阻滞 镇痛效果 产程 分娩结局 不良反应 

分 类 号：R714.3[医药卫生—妇产科学]