Efficacy and safety of different doses of ropivacaine + sufentanil for epidural labor analgesia

摘要

Objective: To study the efficacy and safety of different doses of ropivacaine and sufentanil for epidural labor analgesia. Methods: The primiparae with single birth and cephalic presentation who underwent vaginal delivery in Chengde Maternal and Child Health Hospital between March 2015 and February 2018 were selected and randomly divided into the group A who received subarachnoid injection of sufentanil 4 μg, the group B who received injection of sufentanil 4 μg + ropivacaine 2 mg and the group C who received injection of sufentanil 4 μg + ropivacaine 3 mg. During childbirth, serum was collected at the first, second and third stages of labor respectively to detect the secretion of pain mediators and oxidative stress mediators; after childbirth, the placenta was collected to determine the expression of stress molecules. Results: At first, second and third stages of labor, serum SP, DYN, NE, PGE2, TNF- 毩 , COR, AT-II and MDA secretion of group B and group C were significantly lower than those of group A whereas SOD and GSH-Px secretion were significantly higher than those of group A, and serum SP, DYN, NE, PGE2, TNF- 毩 , COR, AT-II and MDA secretion of group C were significantly lower than those of group B whereas SOD and GSH-Px secretion were significantly higher than those of group B; after childbirth, GRP78, CHOP, Bax and Caspase-3 mRNA expression in placenta of group B and group C were significantly lower than those of group A whereas Bcl-2 mRNA expression were significantly higher than that of group A, and GRP78, CHOP, Bax and Caspase-3 mRNA expression in placenta of group C were significantly lower than those of group B whereas Bcl-2 mRNA expression was significantly higher than that of group B. Conclusion: The analgesic effect of sufentanil 4 μg + ropivacaine 3 mg for epidural labor analgesia is the most significant.