罗哌卡因复合舒芬太尼在硬膜外麻醉无痛分娩中的临床观察
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摘要
目的研究罗哌卡因复合舒芬太尼在硬膜外麻醉分娩镇痛的安全性及有效性。方法随机选择96例初产临产妇,以入产房的单双例分为两组:A组注入0.2%罗哌卡因与5μg舒芬太尼混合液6m L,后接硬膜外电子止痛泵维持剂量7m L/h(n=48例);B组为普通分娩对照组(n=48例)。观察两组分娩过程的疼痛分级和胎儿评分,产妇的血压心率变化,产妇的VAS评分,产程时间,顺产率,产后尿潴留等情况。结果疼痛分级效果镇痛组显著优于对照组(P<0.01),产程时间长于镇痛组,差异有显著性意义(P<0.05);B组产妇在产程中MAP、HR明显升高,变化有明显差异(P<0.05);A组剖腹产率比普通组低(P<0.05);缩宫素使用率、围生期出血、Apgar评分、产后尿潴留等比较两组无明显差异(P>0.05)。结论罗哌卡因复合舒芬太尼在硬膜外用于分娩镇痛可以降低分娩时期的疼痛,提高舒适度和安全性。
Objective To explore the safety and effectiveness of ropivacaine combined with sufentanil in painless delivor epidural anesthesia. Methods 96 cases of primipara were randomly selected and divided into two groups according to single and double cases in delivery room. Patients in group A were treated with injection of 0.2% ropivacaine and 5μg sufentanil mixture 6m L, and then maintenance dose of epidural analgesia pump 7m L/h(n=48). Patients in group B were treated with general delivery(n=48). Pain classification and fetal outcome during delivery, maternal blood pressure and heart rate changes, maternal VAS score, labor time, labor rate, postpartum urinary retention and so on of the two group were observed. Results The analgesic effect of pain grade group was significantly better than that of control group(P < 0.01). The labor time was longer than that in the analgesia group, and the difference was significant(P < 0.05). The MAP and HR were significantly higher in the group B, and the changes were significantly different(P < 0.05). The caesarean section rate of group A was lower than that of normal group(P < 0.05). There was no significant difference between the two groups(P > 0.05) in the rate of oxytocin use, perinatal bleeding, Apgar score, postpartum urinary retention. Conclusion Ropivacaine combined with sufentanil in painless delivor epidural anesthesia can reduce the pain during childbirth, and improve comfort and safety.
Objective To explore the safety and effectiveness of ropivacaine combined with sufentanil in painless delivor epidural anesthesia. Methods 96 cases of primipara were randomly selected and divided into two groups according to single and double cases in delivery room. Patients in group A were treated with injection of 0.2% ropivacaine and 5μg sufentanil mixture 6m L, and then maintenance dose of epidural analgesia pump 7m L/h(n=48). Patients in group B were treated with general delivery(n=48). Pain classification and fetal outcome during delivery, maternal blood pressure and heart rate changes, maternal VAS score, labor time, labor rate, postpartum urinary retention and so on of the two group were observed. Results The analgesic effect of pain grade group was significantly better than that of control group(P < 0.01). The labor time was longer than that in the analgesia group, and the difference was significant(P < 0.05). The MAP and HR were significantly higher in the group B, and the changes were significantly different(P < 0.05). The caesarean section rate of group A was lower than that of normal group(P < 0.05). There was no significant difference between the two groups(P > 0.05) in the rate of oxytocin use, perinatal bleeding, Apgar score, postpartum urinary retention. Conclusion Ropivacaine combined with sufentanil in painless delivor epidural anesthesia can reduce the pain during childbirth, and improve comfort and safety.
引文
[1]杨捷.舒芬太尼配伍罗哌卡因硬膜外麻醉在无痛分娩中的效果观察[J].中国医院用药评价与分析,2015,15(12):1605-1608.
[2]岳嵩,冯承新.盐酸罗哌卡因复合舒芬太尼硬膜外自控分娩镇痛的临床观察[J].中国医药导报,2010,7(3):177.
[3]袁宝洁.罗哌卡因复合舒芬太尼硬膜外麻醉和腰硬联合阻滞麻醉用于无痛分娩的临床观察[J].黑龙江医学,2014,57(11):1278-1279.
[4]白芬茹,丁建芳.盐酸罗哌卡因联合舒芬太尼硬膜外麻醉无痛分娩临床观察[J].临床医药实践,2011,20(5):398-399.
[5]张晓俊,蔡海琴.罗哌卡因复合舒芬太尼用于妊娠期高血压疾病患者无痛分娩的临床观察[J].中国妇幼保健,2013,28(32):5365-5367.
[6]李晓红,王克涛,李娅,等.0.1%罗哌卡因复合舒芬太尼用于无痛分娩的效果[J].中国医药导报,2016,13(27):131-134.
[7]彭建军.舒芬太尼配伍罗哌卡因硬膜外麻醉在无痛分娩中的应用效果[J].现代诊断与治疗,2015,26(19):4365-4366.
[8]王晓燕,陈弋戈,鲍二臣,等.罗哌卡因与舒芬太尼在硬膜外无痛分娩中的应用效果分析[J].中国卫生标准管理,2015,6(32):196-198.
[9]周昶碧,方丽珊,郑细妹,等.罗哌卡因复合舒芬太尼用于硬膜外无痛分娩临床观察[J].海峡药学,2015,27(12):94-96.
[10]朱全忙.罗哌卡因复合舒芬太尼连续硬膜外镇痛用于无痛分娩的效果[J].中华全科医学,2015,13(9):1550-1551.
[11]付利英,靳伟红,张梅花,等.罗哌卡因复合舒芬太尼不同麻醉方式用于无痛分娩对母婴结局的影响差异分析[J].临床合理用药杂志,2015,8(19):63-64.
[12]姜文莉.盐酸罗哌卡因联合舒芬太尼硬膜外麻醉用于无痛分娩的临床效果[J].世界临床医学,2017,11(2):143.
[13]李京玮,崔家帅.无痛分娩单纯罗哌卡因与合用舒芬太尼的对比观察[J].现代诊断与治疗,2014,25(16):3802-3803.
[14]韦荣华.罗哌卡因复合舒芬太尼用于硬膜外镇痛分娩120例临床观察[J].右江民族医学院学报,2013,35(6):805-806.
[15]吴桂寿,郑成辉,上官明化,等.腰硬联合阻滞麻醉复合不同剂量舒芬太尼在分娩潜伏期镇痛中的临床应用[J].中国当代医药,2013,20(34):113-114.
[2]岳嵩,冯承新.盐酸罗哌卡因复合舒芬太尼硬膜外自控分娩镇痛的临床观察[J].中国医药导报,2010,7(3):177.
[3]袁宝洁.罗哌卡因复合舒芬太尼硬膜外麻醉和腰硬联合阻滞麻醉用于无痛分娩的临床观察[J].黑龙江医学,2014,57(11):1278-1279.
[4]白芬茹,丁建芳.盐酸罗哌卡因联合舒芬太尼硬膜外麻醉无痛分娩临床观察[J].临床医药实践,2011,20(5):398-399.
[5]张晓俊,蔡海琴.罗哌卡因复合舒芬太尼用于妊娠期高血压疾病患者无痛分娩的临床观察[J].中国妇幼保健,2013,28(32):5365-5367.
[6]李晓红,王克涛,李娅,等.0.1%罗哌卡因复合舒芬太尼用于无痛分娩的效果[J].中国医药导报,2016,13(27):131-134.
[7]彭建军.舒芬太尼配伍罗哌卡因硬膜外麻醉在无痛分娩中的应用效果[J].现代诊断与治疗,2015,26(19):4365-4366.
[8]王晓燕,陈弋戈,鲍二臣,等.罗哌卡因与舒芬太尼在硬膜外无痛分娩中的应用效果分析[J].中国卫生标准管理,2015,6(32):196-198.
[9]周昶碧,方丽珊,郑细妹,等.罗哌卡因复合舒芬太尼用于硬膜外无痛分娩临床观察[J].海峡药学,2015,27(12):94-96.
[10]朱全忙.罗哌卡因复合舒芬太尼连续硬膜外镇痛用于无痛分娩的效果[J].中华全科医学,2015,13(9):1550-1551.
[11]付利英,靳伟红,张梅花,等.罗哌卡因复合舒芬太尼不同麻醉方式用于无痛分娩对母婴结局的影响差异分析[J].临床合理用药杂志,2015,8(19):63-64.
[12]姜文莉.盐酸罗哌卡因联合舒芬太尼硬膜外麻醉用于无痛分娩的临床效果[J].世界临床医学,2017,11(2):143.
[13]李京玮,崔家帅.无痛分娩单纯罗哌卡因与合用舒芬太尼的对比观察[J].现代诊断与治疗,2014,25(16):3802-3803.
[14]韦荣华.罗哌卡因复合舒芬太尼用于硬膜外镇痛分娩120例临床观察[J].右江民族医学院学报,2013,35(6):805-806.
[15]吴桂寿,郑成辉,上官明化,等.腰硬联合阻滞麻醉复合不同剂量舒芬太尼在分娩潜伏期镇痛中的临床应用[J].中国当代医药,2013,20(34):113-114.