汪自欣 姚晓君 舒丽丽

【摘要】 目的：探討罗哌卡因复合舒芬太尼麻醉应用于分娩镇痛中的临床效果。方法：选取本院2018年1-6月收治的分娩镇痛产妇90例为研究对象，按照随机双盲法分为复合组与对照组，各45例。对照组接受罗哌卡因镇痛，复合组接受罗哌卡因复合舒芬太尼麻醉方案处理。比较两组麻醉效果、镇痛起效时间、完全运动阻滞发生率、镇痛持续时间，记录不良反应，比较分娩镇痛前、麻醉后2、8 h疼痛程度（VAS评分）。结果：复合组产妇镇痛起效时间短于对照组，完全运动阻滞发生率低于对照组，镇痛持续时间长于对照组，比较差异均有统计学意义（P<0.05）；复合组产妇麻醉优良率为95.56%，高于对照组的80.00%（P<0.05）；两组分娩镇痛前产妇VAS评分比较差异无统计学意义（P>0.05），复合组麻醉后2、8 h时VAS评分均低于对照组，比较差异均有统计学意义（P<0.05）；复合组产妇不良反应发生率为6.67%，低于对照组的13.33%，但比较差异无统计学意义（P>0.05）。结论：分娩镇痛中应用罗哌卡因复合舒芬太尼镇痛可以更好地提高麻醉效果，而且能缩短麻醉起效时间，降低VAS评分，延长镇痛时间，而且安全性高，对缓解产程期间的分娩疼痛也有促进作用，值得推广。

【关键词】 分娩镇痛； 罗哌卡因； 舒芬太尼； 硬膜外麻醉； 效果

【Abstract】 Objective：To explore the clinical effect of Ropivacaine combined with Sufentanil in labor analgesia.Method：A total of 90 parturients of labor analgesia in our hospital from January to June 2018 were selected.According to the double blind method，they were divided into compound group and control group，45 cases in each group.The control group received Ropivacaine analgesia，and compound group received Ropivacaine combined with Sufentanil anesthesia.The anesthesia effect，onset time of analgesia，incidence of complete motor block and duration of analgesia between two groups were compared，adverse reactions were recorded，the pain level（VAS score） before delivery，after anesthesia 2 and 8 h of two groups were compared.Result：The onset time of analgesia in compound group was shorter than that of control group，the incidence of complete motor block was lower than that of control group，and the duration of analgesia was longer than that of control group，the differences were statistically significant（P<0.05）.The excellent and good rate of anesthesia in combined group was 95.56%，which was higher than 80.00% of control group（P<0.05）.The VAS scores of two groups before delivery analgesia was compared，the difference was not statistically significant（P>0.05），after anesthesia 2 and 8 h，the VAS scores of combined group were lower than those of control group（P<0.05）.The incidence of adverse reactions was 6.67% in compound group，which was lower than 13.33% in control group，but the difference was not statistically significant（P>0.05）.Conclusion：The analgesic effect of Ropivacaine and Sufentanil in labor analgesia can improve the effect of anesthesia，shorten the onset time of anesthesia，reduce the VAS score，prolong the time of analgesia，and have high safety.It can also promote the pain of labor during the period of labor，and is worth promoting.

【Key words】 Labor analgesia； Ropivacaine； Sufentanil； Epidural anesthesia； Effect

First-authors address：Guangzhou Womens and Childrens Medical Center，Guangzhou 510623，China

doi：10.3969/j.issn.1674-4985.2018.31.004

剖宫产率在近几年有所升高，主要在于自然分娩产痛给产妇带来肉体与精神双重打击，使得一些产妇恐惧与焦虑感增加，丧失自然分娩信心，从而选择剖宫产处理[1]。剖宫产期间，为了尽量减轻分娩期间的疼痛，需要借助麻醉药物处理，选择一种合适的麻醉方法处理分娩镇痛，对于产妇顺利分娩，改善新生儿出生质量均有积极的意义[2-5]。硬膜外麻醉方式在分娩阵痛中显示了良好的优势，罗哌卡因与舒芬太尼在这种麻醉方案中比较常用。……