小剂量罗哌卡因联合舒芬太尼腰硬联合麻醉对产妇无痛分娩镇痛情况、产程时间及新生儿结局的影响

doi:10.3969/j.issn.1671-7171.2022.04.014

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摘要【目的】探究小剂量罗哌卡因联合舒芬太尼腰硬联合麻醉对产妇无痛分娩镇痛情况、产程时间及新生儿结局的影响。【方法】选取2019年10月至2020年6月于宝鸡市中心医院实施无痛分娩的88例产妇,分为观察组(44例)和对照组(44例),分组方法为随机数字表法。对照组采用小剂量罗哌卡因联合舒芬太尼硬膜外麻醉,观察组实施小剂量罗哌卡因联合舒芬太尼腰硬联合麻醉,对比两组无痛分娩镇痛情况、产程时间及新生儿结局。【结果】与镇痛前比较,两组镇痛后5 min、10 min及30 min VAS评分均依次递减,不同时间点VAS评分的比较差异均有统计学意义(P<0.05);在镇痛后5~30 min,观察组VAS评分、局麻药使用量、感觉阻滞及运动阻滞起效时间、最大感觉阻滞平面均低于对照组;麻醉维持时间长于对照组,其差异均有统计学意义(P<0.05)。观察组第一产程、第二产程及总产程均短于对照组(P<0.05),但中转剖宫产率、新生儿出生后1 min及5 min 的Apgar 评分与对照组比较差异均无统计学意义(P>0.05)。观察组不良事件总发生率低于对照组(4.55% vs 18.18%),差异均有统计学意义(χ²=4.062,P<0.05)。【结论】小剂量罗哌卡因联合舒芬太尼腰硬联合麻醉可提高无痛分娩镇痛效果,减少麻醉药物使用量,缩短产程,降低不良事件发生率。

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	赵蕊
	杨永朋

关键词 ：镇痛,产科, 酰胺类/治疗应用, 舒芬太尼/治疗应用, 妊娠结局, 分娩,产道

Abstract：【Objective】To explore the effects of combined spinal-epidural anesthesia with low dose ropivacaine and sufentanil on painless labor analgesia, duration of labor and neonatal outcomes. 【Methods】From October 2019 to June 2020, 88 cases of puerperas with painless delivery in Baoji Central Hospital were selected, and they were divided into observation group (44 cases) and control group (44 cases), the grouping method was random number table. The control group was given epidural anesthesia with low-dose ropivacaine and sufentanil, while the study group was given combined spinal-epidural anesthesia with low dose ropivacaine and sufentanil, the painless labor analgesia, labor process time and neonatal outcomes were compared between the two groups. 【Results】 Compared with that before analgesia, the VAS scores of the two groups decreased at 5 min, 10 min and 30 min after analgesia, and there were significant differences in VAS scores at different time points (P<0.05); At 5-30 min after analgesia, VAS score, local anesthetic dosage, onset time of sensory block and motor block and maximum sensory block plane in the observation group were lower than those in the control group; The duration of anesthesia was longer than that of the control group, and the difference was statistically significant (P<0.05). The first stage of labor, the second stage of labor and the total stage of labor in the observation group were shorter than those in the control group (P<0.05), but there was no significant difference in the rate of conversion to cesarean section and Apgar scores at 1 min and 5 min after birth between the observation group and the control group (P>0.05). The total incidence of adverse events in the observation group was lower than that in the control group (4.55% vs 18.18%), and the difference was statistically significant (χ²=4.062, P<0.05).【Conclusion】 Combined spinal-epidural anesthesia with low dose ropivacaine and sufentanil can improve the analgesic effect of painless labor, reduce the use of narcotic drugs, shorten the labor process and reduce the incidence of adverse events.

Key words： Analgesia, Obstetrical Amides /TU Sufentanil/TU Pregnancy Outcome Parity Labor, Obstetric

收稿日期: 2021-12-05

中图分类号:

R714.3

通讯作者: *E-mail:848974748@qq.com

引用本文:

赵蕊, 杨永朋. 小剂量罗哌卡因联合舒芬太尼腰硬联合麻醉对产妇无痛分娩镇痛情况、产程时间及新生儿结局的影响[J]. 医学临床研究, 2022, 39(4): 528-531.
ZHAO Rui, YANG Yong-peng. Effects of Combined Spinal-Epidural Anesthesia with Low Dose Ropivacaine and Sufentanil on Painless Labor Analgesia, Duration of Labor and Neonatal Outcomes. JOURNAL OF CLINICAL RESEARCH, 2022, 39(4): 528-531.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.04.014 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I4/528

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