罗哌卡因联合舒芬太尼或芬太尼在硬膜外分娩镇痛中的对比研究(1)
【摘要】 目的：探究罗哌卡因联合舒芬太尼或芬太尼在硬膜外分娩镇痛中的效果对比。方法：选取2017年5月-2019年2月笔者所在医院接受硬膜外分娩镇痛的产妇100例为研究对象，采用随机数字表法将其分为对照组(50例)与观察组(50例)。对照组采用罗哌卡因联合芬太尼进行麻醉，观察组采用罗哌卡因联合舒芬太尼进行麻醉，比较两组产妇麻醉效果、新生儿5 min Apgar评分、VAS评分、麻醉指标、不同产程时间及术中出血量。结果：观察组麻醉优良率为98.00%，明显优于对照组的86.00%，差异有统计学意义(P<0.05)。观察组VAS评分、镇痛起效时间、完全阻滞时间均优于对照组，差异有统计学意义(P<0.05)。两组新生儿5 min Apgar评分、不同产程时间及术中出血量比较，差异均无统计学意义(P>0.05)。结论：罗哌卡因联合舒芬太尼用于产妇硬膜外分娩镇痛中具有显著的麻醉效果，同时麻醉起效快，有效减轻产妇的疼痛情况，同时对新生儿不会造成影响，具有较高的安全性。
【关键词】 罗哌卡因 舒芬太尼 芬太尼 分娩 硬膜外镇痛
[Abstract] Objective： To explore the effect of Ropivacaine combined with Sufentanyl or Fentanyl on epidural labor analgesia. Method： A total of 100 cases of parturients who received epidural labor analgesia in our hospital from May 2017 to February 2019 were selected as the study objects， and were divided into the control group (50 cases) and the observation group (50 cases) with the method of random number table. The control group was anesthetized with Ropivacaine combined with Fentanyl， while the observation group was anesthetized with Ropivacaine combined with Sufentanyl. The anesthetic effect， newborn Apgar score of 5 min， VAS score， anesthetic index， different durations of labor and intraoperative blood loss were compared between the two groups. Result： The excellent and good rate of anesthesia in the observation group was 98.00%， which was significantly better than 86.00% in the control group， and the difference was statistically significant (P<0.05). The VAS score， analgesia onset time， complete block time in the observation group were all better than those in the control group， the differences were statistically significant(P<0.05). There were no significant differences in Apgar score of 5 min， different labor duration and intraoperative blood loss between the two groups(P>0.05). Conclusion： Ropivacaine combined with Sufentanyl has a significant anesthetic effect in the analgesia of parturient epidural labor. At the same time， the effect of anesthesia is fast， and it can effectively reduce the pain of parturients. At the same time， it will not affect the newborn， so it has a high safety.
分娩是妊娠女性都要經历的一个复杂生理过程，分娩过程中会使产妇出现剧烈的疼痛，进而导致能自然分娩的产妇选择剖宫产[1]。随着人们生活水平的不断提高，选择分娩镇痛的产妇也随之增多，分娩镇痛主要是在产妇进入产程后实施，不影响产妇分娩能力的硬膜外镇痛[2]。目前临床中用于硬膜外分娩镇痛的麻醉药物主要有罗哌卡因、舒芬太尼及芬太尼，主要麻醉方案有罗哌卡因联合芬太尼，以及罗哌卡因联合舒芬太尼，本研究选取笔者所在医院100例产妇进行研究，旨在进一步对比研究这两种方案对分娩镇痛的效果，现报道如下。
1 资料与方法
1.1 一般资料
选取2017年5月-2019年2月笔者所在医院接受硬膜外分娩镇痛的产妇100例为研究对象，纳入标准：自愿接受硬膜外分娩镇痛;胎儿足月且为单胎妊娠;具有正常的理解沟通交流能力[3]。排除标准：伴有严重肝肾疾病、妊娠并发症及精神疾病;自然分娩中转为剖宫产的产妇;存在麻醉药物禁忌及阴道分娩禁忌证;分娩后先天性畸形、先天性痴呆、先天性心肺疾病的新生儿[4]。采用随机数字表法将其分为对照组(50例)与观察组(50例)。对照组年龄22～34岁，平均(29.61±4.33)岁;孕周37～40周，平均(39.24±2.05)周;初产妇23例，经产妇27例。观察组年龄21～35岁，平均(29.84±4.67)岁;孕周38～41周，平均(39.95±2.17)周;初产妇21例，经产妇29例。两组产妇一般资料比较差异无统计学意义(P>0.05)，有可比性。产妇及其家属均对本研究知情同意，并签署知情同意书。本研究在笔者所在医院伦理委员会的批准下开展。, http://www.100md.com(郑锦 陈延波 蔡美云)
【关键词】 罗哌卡因 舒芬太尼 芬太尼 分娩 硬膜外镇痛
[Abstract] Objective： To explore the effect of Ropivacaine combined with Sufentanyl or Fentanyl on epidural labor analgesia. Method： A total of 100 cases of parturients who received epidural labor analgesia in our hospital from May 2017 to February 2019 were selected as the study objects， and were divided into the control group (50 cases) and the observation group (50 cases) with the method of random number table. The control group was anesthetized with Ropivacaine combined with Fentanyl， while the observation group was anesthetized with Ropivacaine combined with Sufentanyl. The anesthetic effect， newborn Apgar score of 5 min， VAS score， anesthetic index， different durations of labor and intraoperative blood loss were compared between the two groups. Result： The excellent and good rate of anesthesia in the observation group was 98.00%， which was significantly better than 86.00% in the control group， and the difference was statistically significant (P<0.05). The VAS score， analgesia onset time， complete block time in the observation group were all better than those in the control group， the differences were statistically significant(P<0.05). There were no significant differences in Apgar score of 5 min， different labor duration and intraoperative blood loss between the two groups(P>0.05). Conclusion： Ropivacaine combined with Sufentanyl has a significant anesthetic effect in the analgesia of parturient epidural labor. At the same time， the effect of anesthesia is fast， and it can effectively reduce the pain of parturients. At the same time， it will not affect the newborn， so it has a high safety.
分娩是妊娠女性都要經历的一个复杂生理过程，分娩过程中会使产妇出现剧烈的疼痛，进而导致能自然分娩的产妇选择剖宫产[1]。随着人们生活水平的不断提高，选择分娩镇痛的产妇也随之增多，分娩镇痛主要是在产妇进入产程后实施，不影响产妇分娩能力的硬膜外镇痛[2]。目前临床中用于硬膜外分娩镇痛的麻醉药物主要有罗哌卡因、舒芬太尼及芬太尼，主要麻醉方案有罗哌卡因联合芬太尼，以及罗哌卡因联合舒芬太尼，本研究选取笔者所在医院100例产妇进行研究，旨在进一步对比研究这两种方案对分娩镇痛的效果，现报道如下。
1 资料与方法
1.1 一般资料
选取2017年5月-2019年2月笔者所在医院接受硬膜外分娩镇痛的产妇100例为研究对象，纳入标准：自愿接受硬膜外分娩镇痛;胎儿足月且为单胎妊娠;具有正常的理解沟通交流能力[3]。排除标准：伴有严重肝肾疾病、妊娠并发症及精神疾病;自然分娩中转为剖宫产的产妇;存在麻醉药物禁忌及阴道分娩禁忌证;分娩后先天性畸形、先天性痴呆、先天性心肺疾病的新生儿[4]。采用随机数字表法将其分为对照组(50例)与观察组(50例)。对照组年龄22～34岁，平均(29.61±4.33)岁;孕周37～40周，平均(39.24±2.05)周;初产妇23例，经产妇27例。观察组年龄21～35岁，平均(29.84±4.67)岁;孕周38～41周，平均(39.95±2.17)周;初产妇21例，经产妇29例。两组产妇一般资料比较差异无统计学意义(P>0.05)，有可比性。产妇及其家属均对本研究知情同意，并签署知情同意书。本研究在笔者所在医院伦理委员会的批准下开展。, http://www.100md.com(郑锦 陈延波 蔡美云)