摘要
目的观察左布比卡因+舒芬太尼和罗哌卡因+舒芬太尼对足月初产妇分娩镇痛的效果及安全性。方法选取2018年9月至2019年11月分娩的足月初产妇180例为研究对象,随机分为对照组和观察组,每组90例。对照组采用布比卡因+舒芬太尼的镇痛方案,观察组采用罗哌卡因+舒芬太尼的镇痛方案,比较2组产妇不同时间点的VAS评分、产程时间、分娩结局、新生儿1、5min的Apgar评分、新生儿窘迫发生率、运动阻滞情况及低血压、恶心呕吐等不良反应的发生率。结果2组产妇镇痛后VAS评分均较镇痛前显著降低(P<0.01),其中观察组产妇阵痛后VAS 1h、2h与宫口全开时评分明显低于对照组(P<0.05)。2组产妇的产程时间、分娩结局、新生儿Apgar评分及窘迫发生率的比较均无统计学意义(P>0.05)。2组产妇运动阻滞、低血压、呼吸抑制及PDPH的发生率比较无统计学意义(P>0.05),观察组产妇用药后恶心呕吐及皮肤瘙痒的发生率较对照组明显降低(P<0.05)。结论两种镇痛方案镇痛效果理想、对产妇与新生儿的影响较低,均可满足初产妇对分娩镇痛的需求,其中罗哌卡因+舒芬太尼镇痛效果较左布比卡因+舒芬太尼好,不良反应更少,安全性较高。
Objective To investigate the effects and safety of levobupivacaine+sufentanil and ropivacaine+sufentanil on delivery analgesia in term primiparas.Methods A total of 180 full-term primiparas who underwent delivery in our hosp1ital from September 2018 to November 2019 enrolled in the study,who were randomly divided into control group and observation group,with 90 cases in each group.The primiparas in control group were treated by analgesia scheme of bupivacaine+sufentanil,however,thosei n observation group were treated by analgesia scheme of ropivacaine+sufentanil.The VAS scores,labor time,delivery outcomes,and Apgar scores of 1min and 5min of neonates,and the incidence rate of neonatal distress,motion block,and incidence rate of hypotension,nausea and vomiting were observed and compared between the two groups.Results After analgesia,the VAS scores in both groups were significantly lower than those before the analgesia(P<0.01),in which,the scores of VAS at 1h,2h and the full opening of the cervix in observation group were significantly lower than those in control group(P<0.05).There were no statistically significant differences in the labor duration,delivery outcomes,Apgar scores and incidence rate of distress,and the incidence rates of maternal blockade,hypotension,respiratory depression and PDPH between the two groups(P>0.05).However the incidence rates of nausea,vomiting,and itching in observation group were significantly lower than those in control group(P<0.05).Conclusion Both analgesia schemes have ideal analgesic effects and lower influence on the mother and neonates.However the analgesic effects of ropivacaine+sufentanil are superior to those of levobupivacaine+sufentanil,with fewer side effects and higher safety.
作者
曹丽爽
张娜
CAO Lishuang;ZHANG Na(Department of Obstetrics,Ningjin County Hospital for Maternal and Child Health, Hebei,Ningjin 055550,China)
出处
《河北医药》
CAS
2021年第4期596-598,共3页
Hebei Medical Journal
基金
邢台市重点研发计划项目(编号:2020ZC351)。
