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舒芬太尼复合罗哌卡因用于硬膜外镇痛对正常分娩孕妇的镇痛效果、分娩过程和预后的回顾性队列研究。

Analgesic Effects, Birth Process, and Prognosis of Pregnant Women in Normal Labor by Epidural Analgesia Using Sufentanil in Combination with Ropivacaine: A Retrospective Cohort Study.

机构信息

Department of Obstetrics, Nantong Maternal and Child Health Hospital, Nantong 226000, China.

Anesthesiology Department, Nantong Maternal and Child Health Hospital, Nantong 226000, China.

出版信息

Comput Intell Neurosci. 2022 Aug 29;2022:1228006. doi: 10.1155/2022/1228006. eCollection 2022.

Abstract

OBJECTIVE

The objective is to evaluate the analgesic, labor, and prognostic effects of patient-controlled epidural analgesia (PCEA) versus sufentanil in conjunction with ropivacaine in normal labor.

METHODS

Sixty pregnant women who had a normal delivery at our hospital between February 2019 and April 2021 were included. Pregnant women were arbitrarily assigned to a control group and a research group. Pregnant women in the control group received lidocaine analgesia and PCEA with sufentanil combined with ropivacaine in the research group. Satisfaction with care, fetal umbilical artery blood flow, VAS score, labor and bleeding, neonatal Apgar score and incidence of adverse events were analyzed.

RESULTS

First, we made a comparison of satisfactory performance of nursing care. The satisfaction rate of the research group was 100.00%, compared to 83.33% for the control group. Nursing satisfaction was higher in the research group, and the difference was statistically significant ( < 0.05). Following analgesia, PI, RI, and S/D values of umbilical artery blood flow were lower in the research group than those in the control group, but the difference was not statistically significant ( > 0.05). The VAS scores at 10 min, 20 min, and 30 min were found to be lower in the research group than in the control group after analgesia, and the difference was statistically significant ( < 0.05). Bleeding was significantly lower in the research group for all stages of labor, and the difference was statistically significant ( < 0.05). Apgar scores at 1 minute, 5 minutes, and 10 minutes postpartum were greater in the research group than in the control group, and the difference was statistically significant ( < 0.05). As a final note, the incidence of pruritus, hypotension, respiratory depression, nausea, and vomiting was found to be lower in the research group than in the control group, and the difference was statistically significant ( < 0.05).

CONCLUSION

PCEA with sufentanil coupled with ropivacaine was used to perform labor analgesia. With significant reduction in maternal pain and assurance of labor, ropivacaine combined with sufentanil epidural labor analgesia did not reduce fetal umbilical artery blood flow without extended labor. It could not affect the labor process or the safety of the fetus, which is safe for the mother and fetus.

摘要

目的

评估患者自控硬膜外镇痛(PCEA)与舒芬太尼联合罗哌卡因在正常分娩中的镇痛、分娩和预后效果。

方法

选取 2019 年 2 月至 2021 年 4 月在我院分娩的 60 例正常产妇为研究对象,采用随机数字表法将产妇分为对照组和观察组,各 30 例。对照组产妇给予利多卡因镇痛,观察组产妇给予舒芬太尼复合罗哌卡因 PCEA 镇痛。分析两组产妇护理满意度、胎儿脐动脉血流、VAS 评分、产程及出血量、新生儿 Apgar 评分及不良反应发生情况。

结果

(1)比较两组产妇护理满意度,观察组产妇护理满意度为 100.00%,对照组产妇护理满意度为 83.33%,观察组产妇护理满意度高于对照组,差异有统计学意义( < 0.05)。(2)镇痛后,观察组产妇脐动脉血流的 PI、RI、S/D 值均低于对照组,但差异无统计学意义( > 0.05)。(3)镇痛后 10min、20min、30min 时,观察组产妇 VAS 评分均低于对照组,差异有统计学意义( < 0.05)。(4)观察组产妇各产程出血量均低于对照组,差异有统计学意义( < 0.05)。(5)观察组产妇产后 1min、5min、10min 的 Apgar 评分均高于对照组,差异有统计学意义( < 0.05)。(6)观察组产妇瘙痒、低血压、呼吸抑制、恶心、呕吐发生率均低于对照组,差异有统计学意义( < 0.05)。

结论

舒芬太尼复合罗哌卡因 PCEA 用于分娩镇痛,能显著减轻产妇疼痛,保证分娩,且不减少胎儿脐动脉血流,不延长产程,对产程及胎儿安全性无影响,对母婴均安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/209a/9444351/1438baf27ae2/CIN2022-1228006.001.jpg

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