Objective To investigate the effect of different concentrations of ropivacaine combined with sufentanil for epidural labor analgesia. Methods 200 cases of single birth full-term primiparas were select-ed, and were randomly divided into group A , group B, group C, and group D, with 50 cases in each.Patients received 0.075%, 0.1%, 0.125%, and 0.15% ropivacaine combined with 5 μg/ml sufentanil in the group A, B, C, and D respectively.The patients in the four groups were treated with epidural extradural injection. And among the four groups , it was compared in analgesic time , the visual analogue scale (VAS), the Bromage score, time of labor and the occurrence of adverse reactions. Results Analgesic onset time of group D was the shortest (P＜0.05), and analgesic onset time of group C was also significantly shorter than that of group A and group B (P＜0.05).The dosing interval of group C and group D was significantly longer than that of group A and group B ( P＜0.05).The interval number of group C and group D was significantly less than that of group A and group B (P＜0.05).Maintenance time of the initial dose of group C and group D was significantly longer than that of group A and group B (P＜0.05).There was no significant difference in VAS scores among the four groups when the analgesia starting, 10 minutes and 30 minutes after analgesia, and womb full open-ing (P＞0.05).The incidence of motor block in group A and group B was significantly less than that in group D (P＜0.05), and the degree of motor block in group C was slightly less than that in group D, but there was no significant difference between the two groups ( P＞0.05).The first stage of labor in group A and B was significantly shorter than that in group C and D (P＜0.05), but there was no significant difference be-tween group A and group B ( P＞0.05).And there was no significant difference between group C and group D ( P＞0.05).There was no statistically significant difference in the second and the third stage of labor a-mong the four groups ( P＞0.05).The total incidence of adverse reactions in group D was significantly high-er than that in the other three groups ( P＜0.05), and there was no significant difference among group A, group B and group C (P＞0.05). Conclusion It is recommended of 0.125%ropivacaine combined with 0.5 μg/ml sufentanil for epidural labor analgesia with quick onset, good analgesic effects, fewer side effects, and higher safety.%目的 探讨不同浓度罗哌卡因联合舒芬太尼硬膜外间断注射对硬膜外分娩镇痛起效时间及不良反应的影响. 方法 选取本院产科接收单胎足月初产妇200例,按照随机数表法分成A、B、C、D四组,每组50例,A组:0.075%罗哌卡因+0.5 μg/ml舒芬太尼;B组:0.1%罗哌卡因+0.5 μg/ml舒芬太尼;C组:0.125%罗哌卡因+0.5μg/ml舒芬太尼;D组:0.15%罗哌卡因+0.5μg/ml舒芬太尼,四组均采用硬膜外间断注射给药,观察比较四组产妇镇痛时间、视觉模拟评分法( VAS)、Bromage评分、产程时间、不良反应发生情况. 结果 D组镇痛起效时间最短(P＜0.05),C组镇痛起效时间也明显短于A组、B组(P＜0.05);C组、D组给药间隔显著长于A组、B组(P＜0.05);C组、D组给药次数明显少于A组、B组(P＜0.05);C组、D组初次用药剂量维持时间显著长于A组、B组(P＜0.05);四组产妇镇痛即刻、镇痛10 min、镇痛30 min、子宫口全开时的VAS评分比较差异无统计学意义(P＞0.05); A组、B组产妇出现运动阻滞发生率明显低于D组(P＜0.05),C组产妇出现运动阻滞程度较D组轻微,但两组比较差异无统计学意义(P＞0.05);A、B组第一产程时间明显短于C、D组(P＜0.05),A组与B组比较差异无统计学意义(P＞0.05),C组、D组之间比较差异无统计学意义(P＞0.05);四组第二产程、第三产程比较差异无统计学意义(P＞0.05);D组不良发应总发生率明显高于其他三组(P＜0.05),A组、B组、C组之间比较差异无统计学意义(P＞0.05). 结论 选用0.125%罗哌卡因联合0.5μg/ml舒芬太尼进行硬膜外间断注射对硬膜外分娩镇痛起效快,镇痛效果好,副作用少,安全性高.
展开▼
