|
|
|
| Effects of Patient-Controlled Epidural Analgesia Using Ropivacaine Combined with Sufentanil on Labor Progress and Fever in Women Undergoing Labor Analgesia |
| ZHANG Yanxia |
| Department of Anesthesiology, Minquan County Hospital of Traditional Chinese Medicine, Shangqiu Henan 476800 |
|
|
|
|
Abstract 【Objective】To investigate the effects of patient-controlled epidural analgesia (PCEA) using ropivacaine combined with sufentanil on labor progress and fever in women undergoing labor analgesia. 【Methods】 A total of 96 women who underwent labor analgesia at Minquan County Hospital of Traditional Chinese Medicine from January 2020 to December 2023 were randomly divided into a control group and an observation group, with 48 cases in each group. Both groups received PCEA. The control group received ropivacaine alone, whereas the observation group received ropivacaine combined with sufentanil. The analgesic effects, duration of labor, mode of delivery, and neonatal Apgar scores after delivery were compared between the two groups. Oxidative stress indicators [endothelin, cortisol, and superoxide dismutase (SOD)] and inflammatory factors [interleukin-6 (IL-6), interleukin-10(IL-10), and tumor necrosis factor α (TNF-α)] were measured before analgesia and 1 h after delivery. Visual analog scale (VAS) scores and body temperature were assessed before analgesia, 1 h after analgesia, immediately after delivery, and 1 h after delivery. 【Results】Compared with the control group, the observation group had a shorter onset time of anesthesia, fewer patient-controlled analgesia administrations, and a lower dose of local anesthetic, but a longer duration of anesthesia maintenance (all P<0.05). VAS scores at 1 h after analgesia, immediately after delivery, and 1 h after delivery were lower in the observation group than in the control group (all P<0.05). The rate of vaginal delivery was higher in the observation group than in the control group, and neonatal Apgar scores at 1 and 5 min after delivery were also higher (all P<0.05). 1 h after delivery, the levels of oxidative stress indicators and inflammatory factors in both groups were higher than those before analgesia (all P<0.05); however, the levels of these markers in the observation group were lower than those in the control group (all P<0.05). Body temperatures immediately after delivery and 1 h after delivery in the observation group were lower than those in the control group (all P<0.05). 【Conclusion】PCEA with ropivacaine combined with sufentanil can effectively improve analgesic efficacy, shorten the duration of labor, alleviate postpartum oxidative stress and inflammation, and reduce the risk of elevated maternal body temperature. It is worthy of clinical application.
|
|
Received: 25 November 2025
|
|
|
|
|
|
[1] 陈秀兰,梁亚贵,翁迪贵. 腰硬联合麻醉及连续硬膜外麻醉在顺产经产妇无痛分娩的应用[J]. 福建医科大学学报,2021,55(4):343-345. [2] 邢亚伟. 不同剂量罗哌卡因辅助硬膜外麻醉对产妇分娩的镇痛效果研究[J]. 国际医药卫生导报,2023,29(11):1528-1532. [3] Hu Y, Zhang Q Y, Qin G C,et al. Balanced opioid-free anesthesia with lidocaine and esketamine versus balanced anesthesia with sufentanil for gynecological endoscopic surgery: a randomized controlled trial[J]. Sci Rep, 2024,14(1):11759. [4] 孔德强,王昱,张辉. 舒芬太尼联合罗哌卡因硬膜外麻醉在分娩镇痛中的应用及对产妇妊娠结局的影响[J]. 吉林医学,2023,44(8):2257-2260. [5] Jia Z, Li Y D, Jia H,et al. Curative effect of remifentanil on labor analgesia in newborns[J]. J Matern Fetal Neonatal Med, 2020,33(11):1913-1918. [6] 江苏省新生儿重症监护病房母乳喂养质量改进临床研究协作组. 极低/超低出生体重儿生后1 min低Apgar评分的危险因素:多中心回顾性研究[J]. 中国当代儿科杂志,2023,25(9):909-914. [7] Smith A, Laflamme E, Komanecky C. Pain management in labor[J]. Am Fam Physician, 2021, 103(6):355-364. [8] 姜鹏,黄淑妮,王向东,等. 硬膜外注射罗哌卡因抑制初产妇硬膜外分娩镇痛时爆发痛的效力[J]. 中华麻醉学杂志,2023,43(12):1451-1453. [9] 刘超,陶中龙. 小剂量盐酸罗哌卡因联合舒芬太尼用于剖宫产手术的临床研究[J]. 中国临床药理学杂志,2021,37(2):111-114. [10] Choi W, Ryu H, Fuwad A,et al. Quantitative analysis of the membrane affinity of local anesthetics using a model cell membrane[J]. Membranes (Basel), 2021, 11(8):579. [11] Shi L, Zhang D, Ye P,et al. Clinical effect of different concentrations of ropivacaine in the labor analgesia of dural puncture epidural technique for obese puerperae[J]. Perioper Med (Lond), 2024, 13(1):7-10. [12] Andrade S S, Dos Santos F H, Souza N F,et al. Plasmatic catecholamines after neuraxial labour analgesia: A randomised controlled trial comparing epidural versus combined spinal-epidural[J]. Anaesth Crit Care Pain Med, 2022, 41(6):101148. [13] Yang W Q, Wang Y H, Ko C Y,et al. Effect of lite touch on the anxiety of low-risk pregnant women in the latent phase of childbirth: a randomized controlled trial[J]. Front Psychol, 2024, 15(3):1304274. [14] Wiley K S, Camilo C, Gouveia G,et al. Maternal distress, DNA methylation, and fetal programing of stress physiology in Brazilian mother-infant pairs[J]. Dev Psychobiol, 2023, 65(1):e22352. [15] Lozowchuk A, Carroll J E, Hobel C,et al. Partner relationship quality and IL-6:IL-10 trajectories from pregnancy to a year after-birth[J]. Brain Behav Immun, 2023, 114(3):407-413. [16] Chen X, Zhang Y, Ni X,et al. Effects of labour analgesia with different concentrations of ropivacaine on maternal body temperature and inflammatory factor: A randomised controlled study[J]. Anaesth Crit Care Pain Med, 2022, 41(2):101030. |
|
|
|