Abstract:Objective: To explore the effect of ropivacaine combined with dizosin on epidural labor analgesia on fetus and puerpera. Methods: The subjects were selected from March 2018 to March 2019 in the obstetrics department of Chengde Maternal and Child Health Hospital. 180 cases of primipara with spontaneous delivery were selected. All the primipara were divided into two groups according to the random arrangement method of the patient's admission number. The study group (group D) and the control group (group C) had 90 cases in each group. Group C: no epidural labor analgesia; Group D: PECA analgesia pump: 0.125% ropivacaine + 5 mg of Dzosin + 0.9% sodium chloride injection, a total of 100 ml, background dose of 10 ml/h, additional dose of 8 ml, locking time of 20 minutes. Observed indicators: the duration of labor, the amount of bleeding during delivery, umbilical artery blood gas results and neonatal Apgar score in the two groups. The PI, RI and S/D values of umbilical artery, middle cerebral artery and uterine artery of the two groups were observed by ultrasonography. The adverse reactions of the two groups were recorded. The observation time was 30 minutes before analgesia (T1), 10 minutes after analgesia (T2), 30 minutes after analgesia (T3), 1 hour after analgesia (T4), 2 hours after analgesia (T5), and uterine opening (T6). Maternal adverse reactions were recorded in two groups. Results: There were no significant differences in labor duration, blood gas analysis and Apgar score between the two groups (P>0.05). At T2, the S and D values of uterine artery blood flow in the study group were higher than those in the control group (P<0.05). At different time points, there were no significant differences in P I, RI and S/D between the two groups (P>0.05). There was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion: epidural analgesia with ropivacaine combined with dizosin can significantly relieve the pain of parturient without adverse effects on infants and parturient.
[1] Riazanova OV, Alexandrovich YS, Ioscovich AM. The relationship between labor pain management, cortisol level and risk of postpartum depression development: a prospective nonrandomized observational monocentric trial[J]. Rom Anaesth Intensive Care, 2018,25(2):123~130. [2] 李冰,陈绪军,郭艳,等.不同浓度罗哌卡因复合舒芬太尼在硬膜外阶梯式分娩镇痛中的应用[J].临床麻醉学杂志,2016,32(4):361~365. [3] 吴玲玲,尹玉竹,饶燕珍,等.腰硬联合麻醉分娩镇痛转剖宫产的指征分析[J].中山大学学报(医学科学版),2015,36(5):753~757. [4] Baliuliene V, Macas A, Rimaitis K. The optimal concentration of bupivacaine and levobupivacaine for labor pain management using patient-controlled epidural analgesia: a double-blind, randomized controlled trial[J]. Int Obstet Anesth, 2018,35:17~25. [5] Yuksel H, Cayir Y, Kosan Z, et al. Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial[J].Integr Med, 2017,15(6):456~461. [6] Genc KR, Demirci N, Ender YA, et al. Effects of intradermal sterile water injections in women with low back pain in labor: a randomized, controlled, clinical trial[J]. Balkan Med, 2018,35(2):148~154. [7] Ranjbaran M, Khorsandi M, Matourypour P, et al. Effect of massage therapy on labor pain reduction in primiparous women: a systematic review and meta-analysis of randomized controlled clinical trials in iran[J]. Iran Nurs Midwifery Res, 2017,22(4):257~261. [8] Mdc L, Sgnd G, Ape P, et al. The color of pain: racial iniquities in prenatal care and childbirth in brazil[J]. Cad Saude Publica,2017,33:112~125. [9] van Erp M, Ortner C, Jochberger S, et al. Recent standards in management of obstetric anesthesia[J]. Wien Med Wochenschr,2017,167(15-16): 374~389.