彭昊帅 蒋天青 王青梅 王慧

摘 要 目的：分析盐酸罗哌卡因联合舒芬太尼硬膜外麻醉对于分娩镇痛的效果。方法：选取100例产妇随机分为对照组和观察组各50例。对照组实施盐酸罗哌卡因硬膜外麻醉，观察组在此基础上加用舒芬太尼，比较两组的镇痛效果。结果：两组麻醉后血压、心率、呼吸频率，产妇VAS评分、新生儿Apgar评分，第三产程时间和不良反应发生率，差异无统计学意义（P>0.05）。麻醉后10 min、30 min，观察组VAS评分低于对照组，第一、二产程时间较对照组短（P<0.05）。结论：盐酸罗哌卡因联合舒芬太尼硬膜外麻醉用于分娩镇痛，麻醉起效时间更短，对产妇及胎儿安全无明显影响。

关键词 盐酸罗哌卡因 舒芬太尼 硬膜外麻醉 分娩镇痛

中图分类号：R971.2； R714.3 文献标志码：A 文章编号：1006-1533（2021）23-0058-03

Effect of ropivacaine hydrochloride combined with sufentanil epidural anesthesia in labor analgesia

PENG Haoshuai1， JIANG Tianqing1， WANG Qingmei1， WANG Hui2

（1. Department of Pharmacy， the People’s Hospital of Zhengzhou， Zhengzhou 450000， China； 2. Department of Obstetrics， the People’s Hospital of Zhengzhou， Zhengzhou 450000， China）

ABSTRACT Objective： To analyze the effect of ropivacaine hydrochloride combined with sufentanil epidural anesthesia in labor analgesia. Methods： One hundred cases of parturients were randomly divided into a control group and an observation group with 50 cases each. The control group was given ropivacaine hydrochloride epidural anesthesia， while the observation group was given sufentanil besides ropivacaine hydrochloride. The analgesic effects were compared between the two groups. Results： There were no statistical differences between the two groups in blood pressure， heart rate， respiratory rate after anesthesia， the maternal VAS scores， the Apgar scores of the newborns， the time to the third stage of labor and the incidence of adverse reactions （P>0.05）. The VAS scores at 10 min and 30 min after anesthesia were significantly lower and the times to the first and second stages of labor were shorter in the observation group than the control group （P<0.05）. Conclusion： Ropivacaine hydrochloride combined with sufentanil epidural anesthesia for analgesic delivery has a shorter onset time and no significant effect on the safety of the mother and fetus.

KEY WORDS ropivacaine hydrochloride； sufentanil； epidural anesthesia； labor analgesia

分娩過程多伴随强烈疼痛感，且一直持续至胎儿娩出，疼痛持续时间较长，加上产妇多伴随焦虑、紧张的情绪，导致产妇多倾向选择剖宫产，这也是中国剖宫产率居高不下的主要原因[1]。近年来，分娩镇痛在临床上逐渐推广采用，指的是通过用药物阻断分娩时痛觉神经传递，达到减轻分娩疼痛的目的[2]。分娩镇痛给药方式简单，对母婴结局影响较小，随着临床不断探究发现，硬膜外麻醉在分娩中的镇痛效果优于其他麻醉方式。

1.1 一般资料

选取2019年1月—2020年6月在郑州人民医院生产的产妇100例，随机分为对照组和观察组各50例。其中对照组产妇年龄在23～41岁之间，平均年龄（32.2±1.4）岁，平均孕周（39.6±1.4）周；观察组产妇年龄在22～40岁之间，平均年龄（32.1±1.2）岁，平均孕周（39.8±1.5）周。……