舒芬太尼合用罗哌卡因硬腰联合阻滞在无痛分娩中的运用
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[摘要] 目的 探讨舒芬太尼合用罗哌卡因硬腰联合阻滞在无痛分娩中的应用效果及临床意义。 方法 将2010年12月～2011年12月在我院产科分娩的96例足月、单胎、拟阴道分娩的初产妇随机分为观察组和对照组各48例，观察组给予3 μg舒芬太尼混合3 mg罗哌卡因硬腰联合阻滞麻醉，对照组给予6 μg舒芬太尼阻滞麻醉，观察两组镇痛起效时间、镇痛作用维持时间、各时间点VAS评分情况、各产程所需时间、新生儿Apgar评分及不良反应情况。 结果 观察组镇痛起效时间低于对照组，镇痛维持时间高于对照组（P ＜ 0.05）；观察组各时间点VAS评分比较差异无统计学意义（P ＞ 0.05）；两组各产程所需时间比较差异均无统计学意义（均P ＞ 0.05）；两组新生儿Apgar评分比较无差异无统计学意义（P ＞ 0.05）；观察组皮肤瘙痒及恶心呕吐的发生率均明显低于对照组（均P ＜ 0.05）。 结论 舒芬太尼合用罗哌卡因硬腰联合阻滞用于无痛分娩，具有镇痛效果好、起效时间快、维持时间长、不良反应少等诸多优点，是目前无痛分娩镇痛药物选择的一种较佳方案，值得临床应用推广。
[关键词] 无痛分娩；舒芬太尼；罗哌卡因；腰硬联合阻滞
[中图分类号] R714.3 [文献标识码] A [文章编号] 1673-7210（2012）07（a）-0086-03
Application of Sufentanil combined with Ropivacaine spinal and epidural joint block in painless labor
LIU Xi HE Rulin XU Feng
Department of Anesthesiology, The 123th Hospital of People Liberation Army, Anhui Province, Bengbu 233015, China
[Abstract] Objective To investigate the clinical efficacy and significance of Sufentanil combined with Ropivacaine spinal and epidural joint block in painless labor. Methods 96 cases of full-term, single birth and vaginal delivery primiparas given birth in our hospital from December 2010 to December 2011 were randomly assigned into observation group and control group equally. Patients in observation group were given Sufentanil 3 μg combined with Ropivacaine 3 mg for spinal and epidural block anesthesia and patients in control group were given Sufentanil 6 μg for block anesthesia. Onset time of analgesia, analgesia duration time, VAS scores at each time point, time required of each stage of labor, neonatal Apgar score, and adverse reactions of the two groups were observed and compared. Results Analgesia onset time of the observation group was significantly shorter and analgesia duration was significantly longer (P < 0.05); the difference of VAS scores of different time points in observation group was not statistically significant (P > 0.05); the difference of the required time of each stage of labor was not statistically significant between the two groups (P > 0.05); the difference of neonatal Apgar scores between the two groups was not statistically significant (P > 0.05); occurrence of pruritus, nausea and vomiting were significantly lower in observation group than in control group (P < 0.05). Conclusion Sufentanil combined with Ropivacaine spinal and epidural joint block for painless childbirth has the advantages of good analgesic effect, of quick onset, long duration and few adverse reactions, and thus is currently a preferred option of medication in painless labor, and is worthy of clinical application.