舒芬太尼替代芬太尼应用于分娩镇痛的安全性分析

摘要

Objective To study the effect of sufentanil instead of fentanyl applied in painless labour in pregnant women.Methods A total of 300 primiparas in our hospital were selected as subjects, and randomly assigned to a control group (C) or two treatment groups (F or S groups), with 100 in each group.The C group had natural delivery.The S and F groups were treated with sufentanil and fentanyl in painless labour,respectively.The labour time, VAS scores, complications, and Apgar scores at 1 and 10 min were recorded.Results The labour time was significantly shorter in the C group than the F group [(402.8±81.9) min vs.(476.5±84.8) min, q=9.185, P<0.05].The VAS scores were significantly lower in the S and F groups than that in the C group [(3.0±0.7) points vs.(7.1±0.7) points, q=58.571, P<0.05;(3.3±0.7) points vs.(7.1±0.7) points , q=54.286, P<0.05].There was no significant difference among the three groups in postoperative complications (x2=0.150, P=0.928).The neonatal Apgar scores among the three groups at 1 min and 10 min had significant differences (P<0.05), all of which were above 8 points, without clinical significance.Conclusion Sufentanil applied in painless labour in pregnant women is safe and effective.%目的 探讨舒芬太尼替代芬太尼在无痛分娩应用的安全性和可行性. 方法 将2014年8月-2016年2月在我院接受自然生产的初产妇300例,按患者入院的先后顺序及意愿选择分娩方式分为芬太尼组、舒芬太尼组和对照组3组,每组100例.对照组自然生产,芬太尼组、舒芬太尼组分别采用芬太尼和舒芬太尼无痛分娩,产程若出现宫缩乏力加滴缩宫素.观察总产程时间,视觉模拟评分(visual analogue scale, VAS)进行疼痛评分,并发症,新生儿Apgar 1、10 min评分. 结果总产程时间对照组明显短于芬太尼组[(402.8±81.9)min vs.(476.5±84.8)min,q=9.185,P<0.05];疼痛VAS评分舒芬太尼组、芬太尼组明显低于对照组[(3.0±0.7) 分vs.(7.1±0.7)分,q=58.571, P<0.05;(3.3±0.7)分vs.(7.1±0.7)分,q=54.286,P<0.05].3组产后并发症发生率无统计学差异(x2=0.150,P=0.928).3组新生儿Apgar 1、10 min评分有统计学差异(P<0.05),但都在8分以上,差异无实际临床意义. 结论 舒芬太尼应用于无痛分娩时联合缩宫素能获得满意的镇痛效果,安全有效.