Agrawal Dipti, Makhija Bela, Arora Manjeet, Haritwal Arpana, Gurha Pavan
Resident, Department of Obstetrics and Gynaecology, Batra Hospital and Medical Research Centre , Tughlakabad Institutional Area, New Delhi, India .
Senior Consultant, Department of Obstetrics and Gynaecology, Batra Hospital and Medical Research Centre , Tughlakabad Institutional Area, New Delhi, India .
J Clin Diagn Res. 2014 Oct;8(10):OC03-6. doi: 10.7860/JCDR/2014/9974.4930. Epub 2014 Oct 20.
This study aimed to evaluate the effect of ropivacaine epidural analgesia on duration and outcome of labour in nulliparous parturients of India with parturient not receiving any analgesia.
One hundred and twenty nulliparous parturient in established labour at full term with a singleton vertex presentation were assigned to the study. Parturients who request epidural analgesia were allocated in the epidural group (n=60), whereas those not enthusiastic to labour analgesia were allocated in the control group (n=60).
Epidural analgesia was provided by a bolus injection of 10 ml of ropivacaine 0.2% and 50μg fentanyl and maintained by using a continuous infusion of ropivacaine 0.1% with fentanyl 2μl/ml at a 10ml/hour rate. The outcomes were duration of labour, incidence of cesarean sections and instrumental vaginal delivery and neonatal outcome.
Statistical analysis was conducted using unpaired student t-test and chi-square test as required. All tests of significance were performed using two-tailed probability tests. Differences were considered significant when p-value was <0.05.
The two groups were comparable in terms of socio-demographic data. The mean duration of first stage of labour was shorter in epidural group (4.83 ± 1.59 h) compared with control group (5.48 ± 1.56 h) while the duration of second stage of labour was prolong in epidural group (33.13 ± 12.78 min) as compared to control (27.53 ± 11.73 min). Instrumental vaginal or caesarean delivery rate did not increase in the epidural group. The APGAR scores at 5 min were statistically similar in both groups.
Epidural analgesia by ropivacaine in Indian nulliparous resulted in shorter duration of first stage and prolongs duration of second stage of labour compared with parturients without analgesia; however, instrumental vaginal or caesarean delivery rate does not increase in the epidural group.
本研究旨在评估罗哌卡因硬膜外镇痛对印度初产妇产程及分娩结局的影响，并与未接受任何镇痛的产妇进行比较。
将120例足月单胎头位、已进入产程的初产妇纳入研究。要求硬膜外镇痛的产妇被分配至硬膜外组（n = 60），而对分娩镇痛不感兴趣的产妇被分配至对照组（n = 60）。
通过静脉推注10 ml 0.2%罗哌卡因和50 μg芬太尼进行硬膜外镇痛，并以0.1%罗哌卡因与2 μg/ml芬太尼以10 ml/小时的速率持续输注维持。观察指标包括产程、剖宫产及器械助产率和新生儿结局。
根据需要使用非配对学生t检验和卡方检验进行统计分析。所有显著性检验均采用双侧概率检验。当p值<0.05时，差异被认为具有统计学意义。
两组在社会人口学数据方面具有可比性。硬膜外组第一产程的平均时长（4.83 ± 1.59小时）短于对照组（5.48 ± 1.56小时），而硬膜外组第二产程的时长（33.13 ± 12.78分钟）长于对照组（27.53 ± 11.73分钟）。硬膜外组器械助产或剖宫产率并未增加。两组5分钟时的阿氏评分在统计学上相似。
与未接受镇痛的产妇相比，印度初产妇使用罗哌卡因进行硬膜外镇痛可缩短第一产程时长，但会延长第二产程时长；然而，硬膜外组器械助产或剖宫产率并未增加。
