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| Analgesic Effects of Lidocaine Combined with Ropivacaine Hydrochloride and Sufentanil Citrate on Self-controlled Epidural Labor of Puerperas and its Influence on Lactation Function |
| WANG Zhanhui, LIU Yumei, LIU Xue |
| Jiaozhou Central Hospital, Shandong Qingdao 266300, China |
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Abstract Objective: To explore the analgesic effects of lidocaine combined with ropivacaine hydrochloride and sufentanil citrate on self-controlled epidural labor of puerperas and its influence on lactation function. Methods: 200 cases of primiparas with full-term pregnancy were randomly divided into two groups, namely, each 100 cases in observation group and control group. Control group was given natural delivery with whole-course accompany delivery model, and observation group was given painless delivery (self-controlled epidural labor analgesia of lidocaine + ropivacaine hydrochloride+sufentanil citrate). The analgesic effects, labor process, lactation and stress-related hormones levels were observed in the two groups. Results: There were significant differences in the between-group effects, time-point effects and interaction effects ofbetween-group and time-point of visual analogue scale (VAS) score between the two groups (P<0.05). Immediately after analgesia (T1), at 10min after analgesia (T2), at 30min after analgesia (T3), at 7~8 cm of uterus orifice opening (T4), at complete opening of uterus orifice (T5) and at fetal delivery time (T6), the VAS score in observation group showed a significant downward trend (P<0.05), and the scores in control group showed significant increase firstly and then significant decrease (P<0.05), and the scores at T1~T6 in observation group were significantly lower than those in control group (P<0.05). The active time in first stage of labor in observation group was significantly shorter than that in control group (P<0.05), and there were no significant differences in the first stage of labor latency, the second stage of labor and the third stage of labor between the two groups (P>0.05). The lactation starting time in observation group was significantly shorter than that in control group (P<0.05), and the lactation amount was significantly higher than that in control group (P<0.05). There were significant differences in the between-group effects, time-point effects and interaction effects of between-group and time-point of plasma prolactin (PRL) concentration between the two groups (P<0.05). At 24 h~48 h after delivery, the plasma PRL concentration in the two groups was increased significantly (P<0.05), and the increase in observation group was significantly greater than that in control group (P<0.05). After 30min of delivery, the levels of serum adrenal cortical hormone (ACTH), cortisol (COR), norepinephrine (NE) and epinephrine (E) were significantly decreased in observation group (P<0.05), and the levels were significantly decreased in control group (P<0.05), and the levels of above indicators in observation group were significantly lower than those in control group (P<0.05). Conclusion: The effect of lidocaine combined with ropivacaine hydrochloride and sufentanil citrate is better than that of traditional natural labor. It can obviously reduce labor pain, shorten labor process, reduce stress response, improve lactation function, and achieve the effect of early lactation and multiple lactation.
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2020, Vol. 26 
