小剂量低浓度罗哌卡因单次腰麻联合罗哌卡因+舒芬太尼硬外阻滞在分娩镇痛中的应用价值  

Application Value of Small Dose and Low Concentration Ropivacaine Single Lumbar Anesthesia Combined with Ropivacaine and Sufentanil Epi⁃dural Block in Labor Analgesia

作　　者：郑小林 梁焕强 梁海强 ZHENG Xiaolin;LIANG Huanqiang;LIANG Haiqiang(Department of Anesthesiology,Zhongshan Dongsheng Hospital,Zhongshan 528414,Guangdong,China)

机构地区：[1]中山市东升医院麻醉科,广东中山528414

出　　处：《系统医学》2024年第24期164-167,共4页Systems Medicine

摘　　要：目的 探讨小剂量低浓度罗哌卡因单次腰麻联合罗哌卡因+舒芬太尼硬外阻滞在分娩镇痛中的实际效果。方法 非随机选取2023年6月—2024年6月于中山市东升医院妇产科分娩的80例产妇为研究对象,依据麻醉方案分为对照组(40例,采用舒芬太尼腰麻)和观察组(40例,采用小剂量低浓度罗哌卡因腰麻),对比两组的麻醉阻滞效果(镇痛起效时间及完全阻滞时间)、改良Bromageyg评分、新生儿Apgar评分、产程总时间、生命体征指标、不良反应总发生率。结果 观察组的镇痛起效时间(1.36±0.33)min、完全阻滞时间(3.49±0.12)min,均短于对照组的(5.44±0.56)min、(11.63±1.45)min,差异有统计学意义(t=39.699、35.384,P均<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。两组胎儿娩出时的生命体征指标、改良Bromage评分、产程总时间及新生儿Apgar评分比较,差异无统计学意义(P均>0.05)。结论 应用小剂量、低浓度的罗哌卡因进行腰麻,并联合罗哌卡因与舒芬太尼的硬膜外阻滞,在分娩镇痛方面具有更快的起效速度、更少的不良反应,产妇体验更佳。Objective To analyze the analgesic effect of low-dose and low-concentration ropivacaine combined with ropivacaine and sufentanil epidural block during labor.Methods Eighty parturients who were scheduled to give birth in the Obstetrics and Gynecology Department of Zhongshan Dongsheng Hospital from June 2023 to June 2024 were non-randomly selected as research object and divided into a control group(forty cases,using sufentanil spinal anesthe‐sia)and an observation group(forty cases,using low-dose and low concentration ropivacaine spinal anesthesia)accord‐ing to the anesthesia plans.The anesthesia block effect(analgesic onset time and complete block time),modified Bro‐mageyg score,neonatal Apgar score,total labor time,vital sign indicators,and total incidence of adverse reactions were compared between the two groups.Results The analgesic onset time(1.36±0.33)min and complete block time(3.49±0.12)min in the observation group were shorter than(5.44±0.56)min and(11.63±1.45)min in the control group,and the differences were statistically significant(t=39.699,35.384,both P<0.05).The total incidence of ad‐verse reactions in the observation group was lower than the control group,and the difference was statistically signifi‐cant(P<0.05).There were no statistically significant differences in vital signs,modified Bromage score,total labor time,and neonatal Apgar score at the time of fetal delivery(all P>0.05).Conclusion Low-dose and low-concentration ropivacaine combined with ropivacaine and sufentanil epidural block after lumbar anesthesia has faster analgesic ef‐fect,less adverse reactions and better maternal experience.

关 键 词：分娩镇痛 小剂量 低浓度 罗哌卡因 腰硬联合麻醉 

分 类 号：R614[医药卫生—麻醉学]