罗哌卡因复合舒芬太尼硬膜外麻醉在初产妇经阴道分娩产妇无痛分娩中的应用及对产程及母婴的结局影响

doi:10.3969/j.issn.1006-6233.2018.12.005

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摘要 目的: 研究分析罗哌卡因复合舒芬太尼硬膜外麻醉在初产妇经阴道分娩产妇无痛分娩中的应用及对产程、母婴结局的影响。方法: 选取2017年1月至2017年12月期间在我院接受经阴道分娩的108例初产妇作为研究对象,按照随机数表法分成对照组和观察组,每组54例。对照组产妇采用硬膜外注射罗哌卡因麻醉,观察组产妇接受罗哌卡因复合舒芬太尼硬膜外麻醉。比较两组产妇镇痛指标、不同时间段疼痛程度、产程时间及母婴结局。结果: 观察组产妇镇痛起效时间、完全阻滞时间均低于对照组,镇痛持续时间高于对照组,差异有统计学意义(P<0.05);两组产妇麻醉10min、1h、2h后疼痛VAS评分均低于麻醉前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组产妇第一产程、第二产程、第三产程时间均低于对照组,差异有统计学意义(P<0.05);观察组产妇不良母婴结局发生率5.6%(3/54)低于对照组的18.5%(10/54),差异有统计学意义(P<0.05)。结论: 罗哌卡因复合舒芬太尼硬膜外麻醉在初产妇经阴道分娩产妇无痛分娩中应用效果显著,能有效提高麻醉镇痛效果,减轻产妇分娩疼痛,缩短产程时间,减少不良母婴结局,值得临床推广。

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关键词 ：硬膜外麻醉, 罗哌卡因, 舒芬太尼, 产程, 母婴结局

Abstract：Objective: To study the application of ropivacaine combined with sufentanil epidural anesthesia in primipara of vaginal delivery of painless childbirth and its impact on labor, maternal Methods: 108 cases of primiparous women receiving vaginal delivery in our hospital from January 2017 to December 2017 were enrolled in this study. All the patients were divided into control group and observation group according to random number table method, 54 cases in each group. The women in the control group were given epidural ropivacaine alone for anesthesia, and the women in the observation group were given epidural anesthesia with ropivacaine and sufentanil. The analgesic indexes of the two groups were compared, the degree of pain in different time, the duration of labor and the maternal and infant outcome. Results: The observation group maternal pain onset time, complete block time were lower than the control group, duration of analgesia was higher than the control group, the difference was statistically significant (P<0.05); The VAS scores of pain in two groups were lower than that before anesthesia 10min, 1h and 2h after anesthesia, and the difference was statistically significant (P<0.05). The observation group maternal first stage of labor, the second stage of labor, the third stage of labor time were lower than the control group, the difference was statistically significant (P<0.05); The incidence of adverse maternal-infant outcomes in the observation group was 5.6% (3/54) lower than that in the control group (18.5%, 10/54), the difference was statistically significant (P<0.05). Conclusion: Ropivacaine combined with sufentanil epidural anesthesia in vaginal delivery of primiparous painless childbirth application effect is very significant. It can effectively improve the analgesic effect of anesthesia, and reduce the pain of childbirth delivery, shorten the labor process, reduce the adverse of mother and child. The outcome is worth clinical promotion.

Key words： Epidural anesthesia Ropivacaine Sufentanil Labor Maternal and infant outcome

引用本文:

徐丹,周仕彬,罗方毅,金亮,张明敏,鲁恒. 罗哌卡因复合舒芬太尼硬膜外麻醉在初产妇经阴道分娩产妇无痛分娩中的应用及对产程及母婴的结局影响[J]. 河北医学, 2018, 24(12): 1953-1956.
XU Dan, ZHOU Shibin, LUO Fangyi, et al. The Effect of Ropivacaine Combined with Sufentanil Epidural Anesthesia on Labor-Induced Abortion in Labor of Vaginal Delivery and its Influence on Maternal Birth and Maternal-Infant Outcome. HeBei Med, 2018, 24(12): 1953-1956.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.12.005 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I12/1953

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