摘要
目的 分析硬膜外分娩镇痛时不同剂量镇痛药物对足月妊娠拟阴道试产孕妇的镇痛效果和产后尿潴留发生率的影响。方法 选取延安市博爱医院2021年5月至2022年5月收治的80例足月妊娠拟阴道试产孕妇作为研究对象,采用随机数字表法分为A组和B组,每组40例。两组患者均接受罗哌卡因以及舒芬太尼镇痛,A组孕妇给予0.1%罗哌卡因+0.3μg/mL舒芬太尼镇痛,B组给予0.075%罗哌卡因+0.5μg/mL舒芬太尼镇痛。对比两组产妇手术指标、不同时间点镇痛效果、产后尿潴留发生率及产妇不良分娩结局。结果 两组产妇镇痛时间以及术中出血量比较,差异均无统计学意义(P>0.05)。重复测量方差分析显示:不同时间点VAS评分比较,差异有统计学意义(P<0.05);两组间VAS评分比较,差异无统计学意义(P=0.825);VAS评分的变化不存在时间及组间的交互作用(P=0.208)。与T0比较,两组T1、T2、T3、T4时的VAS评分均降低(P<0.05)。A组尿潴留发生率为7.50%(3/40),B组尿潴留发生率为25.00%(10/40),A组的尿潴留发生率低于B组(P<0.05);A组产妇不良分娩结局率为5.00%(2/40),B组产妇不良分娩结局率为7.50%(3/40),两组差异无统计学意义(P>0.05)。结论 不同剂量硬膜外分娩镇痛均能够起到镇痛的效果,但采用0.075%罗哌卡因+0.5μg/mL舒芬太尼镇痛会升高产妇发生产后尿潴留的风险。
Objective To analyze the analgesia effect of different doses of analgesic drugs during epidural delivery analgesia in full-term pregnant women undergoing vaginal trial delivery and their influence on occurrence rate of postpartum urinary retention.Methods Eighty full-term pregnant women undergoing vaginal trial delivery in the Yan′an Municipal Bo′ai Hospital from May 2021 to May 2022 were enrolled as the study subjects and divided into the group A and B by the random number table method,40 cases in each group.Both groups received ropivacaine and sufentanil analgesia.The group A was given 0.1%ropivacaine plus 0.3μg/mL sufentanil,while the group B received 0.075%ropivacaine plus 0.5μg/mL sufentanil.Then the operation index,analgesic effect at different time points,occurrence rate of postpartum urinary retention and maternal adverse delivery outcome were compared between the two groups.Results The analyesic time and intraoperative bleeding volume showed no statistically significant difference between the two groups(P>0.05).The repeated measurement variance analysis showed that the VAS score at different time points had statistical difference(P<0.05);the VAS score had no statistical difference between the two groups(P=0.825);the change of VAS scores had no interaction in time and group(P=0.208).Compared with that at T0,the VAS scores at T1,T2,T3 and T4 in the two groups all decreased(P<0.05).The occurrence rate of postoperative urinary retention was 7.50%(3/40)in the group A and 25.00%(10/40)in the group B,the group A was lower than the group B(P<0.05).The adverse delivery outcome rates were 5.00%(2/40)in the group A and 7.50%(3/40)in the group B,there was no statistical difference between the two groups(P>0.05).Conclusion Different doses of epidural delivery analgesia have the analgesic effect,but the doses of 0.075%ropivacaine and 0.5μg/mL sufentanil could increase the risk for postpartum urinary retention occurrence in the parturients.
作者
戴娟
刘延东
李永红
DAI Juan;LIU Yandong;LI Yonghong(Department of Obstetrics and Gynecology,Yan′an Municipal Bo′ai Hospital,Yan′an,Shaanxi 716000,China;Department of Anesthesiology,Yan′an Municipal Bo′ai Hospital,Yan′an,Shaanxi 716000,China;Department of Obstetrics and Gynecology,Yan′an Municipal Maternal and Child Health Care Hospital,Yan′an,Shaanxi 716000,China)
出处
《检验医学与临床》
CAS
2023年第24期3681-3684,共4页
Laboratory Medicine and Clinic
关键词
硬膜外分娩镇痛
镇痛药物
足月妊娠
阴道试产
镇痛效果
epidural delivery analgesia
analgesic drug
full-term pregnancy
vaginal trial delivery
analgesia effect
