摘要
目的探讨纳布啡复合罗哌卡因在分娩镇痛中的应用效果及对母儿的影响。方法选择天津市北辰医院2017年2月至2018年12月自愿接受分娩镇痛的120例单胎足月初产妇,分成3组,每组40例。NR组:0.2 mg/mL纳布啡+0.1%罗哌卡因。SR组:0.5μg/mL舒芬太尼+0.1%罗哌卡因。C组不实施镇痛。记录3组产妇镇痛前(T 0)、镇痛后15 min(T 1)、镇痛后30 min(T 2)、宫口开全时(T 3)的VAS评分、Bromage运动阻滞评分,记录NR组和SR组的镇痛平面,分娩期间的不良反应发生情况,缩宫素使用情况。记录新生儿Apgar评分,行血气分析和乳酸值测定,产后24 h由儿科医生测评新生儿神经行为评分(NABA)。分别于分娩镇痛前、产后24 h测定产妇泌乳素水平。结果与C组比较,NR组和SR组T 1、T 2、T 3时VAS评分明显降低(P<0.05)。与SR组比较,C组和NR组恶心、呕吐、瘙痒发生率明显降低。3组产妇Bromage评分、新生儿Apgar评分、脐动脉血气分析和乳酸无明显差异,NR组与SR组镇痛平面为T 10。与C组比较,NR组和SR组产后24 h泌乳素明显升高(P<0.05)。3组新生儿NABA无明显差异。NR组和SR组在缩宫素使用方面略多于C组(P>0.05)。结论纳布啡复合罗哌卡因用于硬膜外自控分娩镇痛效果好,不良反应发生率低,对新生儿无明显影响。
Objective To investigate the application effect of nabulphine combined with ropivacaine in labor analgesia and its influence on maternity and neonate.Methods A total of 120 single birth full term primiparas voluntarily receiving labor analgesia in the Tianjin Municipal Beichen Hospital from July 2017 to December 2018 were selected and divided into 3 groups,40 cases in each group.The NR group:nabulphine 0.2 mg/mL+0.1%ropivacaine.The SR group:sufentanil 0.5μg/mL+0.1%ropivacaine.The group C did not perform analgesia.The VAS scores before analgesia(T 0),at 15 min(T 1)after analgesia,30 min(T 2)after analgesia and full cervical dilatation(T 3)were recorded in 3 groups,as well as the Bromage motor block score,analgesic plane in the NR group and SR group,incidence of adverse reactions during labour and use of vasopressin were recorded.The neonatal Apgar scores were recorded.The blood gas analysis was performed and the lactic acid level was detected.The neonatal NABA at 24 h after delivery was measured by the pediatrician.The prolactin level was tested before delivery analgesia and at 24 h after delivery.Results Compared with the group C,the VAS scores at T 1-T 3 in the NR group and SR group were decreased significantly(P<0.05).Compared with the group SR,the incidence rates of nausea,vomiting and itching in the C group and NR group were decreased significantly.There was no significant difference in maternal Bromage score,neonatal Apgar score,umbilical artery blood gas analysis and lactic acid among 3 groups.The analgesic plane was at T 10 in the NR group and SR group.Compared with the C group,the prolactin level at 24 h after delivery in the NR and SR groups was significantly increased(P<0.05).There was no significant difference in NABA among 3 groups.The vasopressin use in the NR group was slightly more than that in the C group(P>0.05).Conclusion The application of nabulphine combined with ropivacaine in epidural labor analgesia has good effect with low incidence rate of adverse reactions and without significant influence on neonate.
作者
吴慧红
赵君
李玉茹
刘晓东
尹志芳
杜洪印
WU Huihong;ZHAO Jun;LI Yuru;LIU Xiaodong;YIN Zhifang;DU Hongyin(Department of Anesthesiology,Tianjin Municipal Beichen Hospital,Tianjin 300400,China;Department of Obstetrics,Tianjin Municipal Beichen Hospital,Tianjin 300400,China;Department of Anesthesiology,Tianjin Municipal First Central Hospital,Tianjin 300192,China)
出处
《重庆医学》
CAS
2020年第5期728-731,738,共5页
Chongqing medicine
基金
2017年天津市北辰区科技计划医疗卫生类科研项目（2017-SHGY-04）
