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不同浓度舒芬太尼复合罗哌卡因用于分娩镇痛的效果评价
Compare the effect of different concentration of sulfentanyl add ropivacaine during labor under continuous epidural block anesthesia

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DOI:
作者:
唐慧, 陈佳 , 何虹
TangHui , ChengJia ,HeHong
作者单位:
长宁区妇幼保健院
Shanghai Changning Maternity & Infant Health Hospital
关键词:
舒芬太尼 罗哌卡因 自然分娩 硬膜外 分娩镇痛
sulfentanyl， ropivacaine ， natural birth， epidural analgesia， labour analgesia
摘要:
目的 观察不同剂量的舒芬太尼复合罗派卡因用于硬膜外分娩镇痛的效果及对产程的影响，探讨舒芬太尼用于硬膜外分娩镇痛的合适浓度配方。方法 选择足月妊娠初产妇120例，ASAⅠ级,年龄22 - 36岁，根据舒芬太尼浓度不同随机分为4组，每组30例。采用持续硬膜外镇痛，A组：单纯0.1 %罗哌卡因,B组：舒芬太尼0.2ug/ml+0.1%罗哌卡因，C组：舒芬太尼0.4ug/ml+0.1%罗哌卡因，D组：舒芬太尼0.6ug/ml+0.1%罗哌卡因。分别记录硬膜外分娩镇痛前及后10、20、30min及宫口开全时的VAS评分，并观察产程进展、产后出血量及新生儿Apgar评分。结果 四组产妇在镇痛前VAS评分比较差异均无统计学意义（均P>0.05）,10min和20min时A组与B组无差异，与C组、D组差异有统计学意义（P<0.05），30min时与组A相比，各组都无统计学差异（P＞0.05）结论 舒芬太尼复合罗派卡因镇痛用于硬膜外分娩镇痛的效果好于单纯罗哌卡因，舒芬太尼浓度为0.4ug/ml +0.1%罗哌卡因配伍镇痛效果最好，且副作用不增加，对第一、二产程、产后出血以及胎儿娩出后Apgar评分等无影响。
Objective To observe and evaluate the analgesia effect of continuous epidural block anesthesia under labor. Exploring the sufentanil used to epidural proper density of labor analgesia. Methods 120 with full term pregnant cases, ASA Ⅰ - Ⅱ level, age 22-36 years old, according to the concentration of sufentanil randomly divided into four different groups, with 30 cases per group. The continuous epidural analgesia, A group: 0.1% pure ropivacaine, group B: sufentanil 0.2 ug/ml + 0.1% ropivacaine, group C: sufentanil 0.4 ug/ml + 0.1% ropivacaine, group D: sufentanil 0.6 ug/ml + 0.1% ropivacaine. VAS score be recorded before and after PCEA 10, 20, and 30 min. also record the uterine mouth open. all the fetal childbirth, and postpartum blood loss and neonatal Apgar score. Results the sesults of four groups of maternal analgesia before VAS score difference were not statistically significant ( all P > 0.05),10min and 20min in A group and B group no difference, and C group, D group and the difference was statistically significant ( P < 0.05),30min group compared with A, each group had no statistical difference ( P > 0.05). Group D maternal by-reaction incidence was the highest of all groups and there was remarkable significance ( P < 0.05) comparing with the other three groups. There was no significance between three groups ( P > 0.05).Conclusion: 0.4 ug/ml of sufentanil + 0.1% ropivacaine compatibility of optimum analgesic effect is suitable, and can shorten the first stages of labor, and no effect to the second stages of labor and Apgar score.

 

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