罗哌卡因复合舒芬太尼硬膜外镇痛在初产妇自然分娩中的应用效果  

Effect of ropivacaine combined with sufentanil for epidural analgesia during natural delivery in primiparous women

作　　者：史涛 张锦莉 李飞 Shi Tao;Zhang Jinli;Li Fei(Department of Anesthesiology,Tongchuan People’s Hospital,Tongchuan 727031,China;Surgical Anesthesia Center,Xianyang First People’s Hospital,Xianyang 712000,China)

机构地区：[1]铜川市人民医院麻醉科,铜川727031 [2]咸阳市第一人民医院手术麻醉中心,咸阳712000

出　　处：《中国实用医刊》2025年第3期41-44,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析罗哌卡因复合舒芬太尼硬膜外镇痛在初产妇自然分娩中的应用效果。方法队列研究。抽取2021年12月至2023年12月于铜川市人民医院自然分娩的初产妇82例,采用随机数字表法分成对照组和观察组,每组41例。对照组单纯行罗哌卡因硬膜外分娩镇痛,观察组在对照组基础上加用舒芬太尼。比较两组疼痛程度[视觉模拟评分法(VAS)评分]、应激反应[皮质醇(Cor)、去甲肾上腺素(NE)]、产程时间、新生儿出生情况及不良反应。结果镇痛后30 min、第二产程、第三产程,观察组VAS评分均低于对照组(P均<0.05)。观察组第一、二、三产程时间均短于对照组(P均<0.05)。分娩后,观察组Cor、NE水平[(183.21±17.21)、(321.53±37.21)ng/mL]均低于对照组[(208.84±20.56)、(346.25±39.76)ng/mL],P均<0.05。两组新生儿出生体质量、新生儿出生后5 min Apgar评分比较差异未见统计学意义(P>0.05);两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论罗哌卡因+舒芬太尼硬膜外分娩镇痛能缓解自然分娩初产妇疼痛,减轻应激反应,有利于缩短各产程时间,且对新生儿无影响,不良反应较少。Objective To analyze the effects of ropivacaine combined with sufentanil for epidural analgesia during natural delivery in primiparous women.MethodsEighty-two primiparous women who gave birth naturally in Tongchuan People’s Hospital from December 2021 to December 2023 were selected for the cohort study.And they were divided into the control group and the observation group using a random number table method,with 41 cases in each group.The control group received epidural analgesia with ropivacaine alone,while the observation group received sufentanil based on the analgesia recipe in the control group.The pain level assessed by visual analogue scale(VAS)score,stress response assessed by cortisol(Cor)and norepinephrine(NE),labor time,status of newborns,and adverse reactions were compared between the two groups.ResultsThirty minutes after analgesia and at the second and third stages of labor,the VAS scores of the observation group were lower than those of the control group(all P<0.05).The first,second,and third stages of labor in the observation group were shorter than those in the control group(all P<0.05).After delivery,the levels of Cor and NE in the observation group were(183.21±17.21)ng/mL and(321.53±37.21)ng/mL,respectively,which were lower than the(208.84±20.56)ng/mL and(346.25±39.76)ng/mL in the control group(all P<0.05).There was no statistically significant difference in birth weight and 5-minute Apgar score of newborns between the two groups(P>0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).ConclusionsEpidural analgesia with ropivacaine and sufentanil in primiparous women during natural childbirth can alleviate pain,reduce stress reactions,shorten every stage of labor,with no impact on newborns and fewer adverse reactions.

关 键 词：自然分娩 初产妇 硬膜外分娩镇痛 罗哌卡因 舒芬太尼 

分 类 号：R714.3[医药卫生—妇产科学]