罗哌卡因复合舒芬太尼在硬膜外麻醉无痛分娩中临床观察.docVIP

罗哌卡因复合舒芬太尼在硬膜外麻醉无痛分娩中临床观察 　　[摘要] 目的 研究罗哌卡因复合舒芬太尼在硬膜外麻醉分娩镇痛的安全性及有效性。 方法 随机选择96例初产临产妇，以入产房的单双例分为两组：A组注入0.2%罗哌卡因与5μg舒芬太尼混合液6mL，后接硬膜外?子止痛泵维持剂量7mL/h（n=48例）；B组为普通分娩对照组（n=48例）。观察两组分娩过程的疼痛分级和胎儿评分，产妇的血压心率变化，产妇的VAS评分，产程时间，顺产率，产后尿潴留等情况。 结果 疼痛分级效果镇痛组显著优于对照组（P0.05）。 结论 罗哌卡因复合舒芬太尼在硬膜外用于分娩镇痛可以降低分娩时期的疼痛，提高舒适度和安全性。 　　[关键词] 无痛分娩；罗哌卡因；舒芬太尼；硬膜外麻醉 　　[中图分类号] R614 [文献标识码] A [文章编号] 2095-0616（2017）07-134-04 　　Clinical observation of ropivacaine combined with sufentanil in painless delivor epidural anesthesia 　　CHEN Changliang CHEN Yuansheng 　　Department of Anesthesiology， Qingyuan Hospital of Ttraditional Chinese Medicine， Guangdong， Qingyuan 511500， China 　　[Abstract] Objective To explore the safety and effectiveness of ropivacaine combined with sufentanil in painless delivor epidural anesthesia. Methods 96 cases of primipara were randomly selected and divided into two groups according to single and double cases in delivery room. Patients in group A were treated with injection of 0.2% ropivacaine and 5μg sufentanil mixture 6mL， and then maintenance dose of epidural analgesia pump 7mL/h （n=48）. Patients in group B were treated with general delivery （n=48）. Pain classification and fetal outcome during delivery， maternal blood pressure and heart rate changes， maternal VAS score， labor time， labor rate， postpartum urinary retention and so on of the two group were observed. Results The analgesic effect of pain grade group was significantly better than that of control group （P0.05） in the rate of oxytocin use， perinatal bleeding， Apgar score， postpartum urinary retention. Conclusion Ropivacaine combined with sufentanil in painless delivor epidural anesthesia can reduce the pain during childbirth， and improve comfort and safety. 　　[Key words] Painless labor； Ropivacaine； Sufentanil； Epidural anesthesia 　　随着社会的进步，人们对医疗的要求越来越来高，解决在分娩中的疼痛已经刻不容缓，分娩过程中疼痛的影响不管是对孕妇的精神还是对其内环境产生巨大的影响，都会对子宫的收缩和产妇的用力程度造成很大的影响，延长整个围生期的时间，加大胎儿宫内缺氧的风险 ，同时也也会增加剖宫产的概率。随着麻醉技术的不断发展，无痛分娩逐渐在临床得到广泛应用，其中盐酸罗哌卡因联合舒芬太尼硬膜外麻醉属于常用