摘要
目的研究罗哌卡因联合纳布啡硬膜外间歇脉冲式注射(PIEB)在阴道分娩产妇的应用效果。方法选取2022年1月至2023年1月新乡市妇幼保健院阴道分娩产妇82例,按照随机数字表法分为对照组(41例)和试验组(41例)。对照组接受罗哌卡因PIEB,试验组接受罗哌卡因联合纳布啡PIEB。对比两组不同时间段[分娩镇痛前(T_(0))、镇痛后30 min(T_(1))、镇痛后1 h(T_(2))、镇痛后2 h(T_(3))、宫口全开时(T_(4))、分娩时(T_(5))]视觉模拟评分法(VAS)评分;对比两组产程时间和自控镇痛次数;对比两组分娩镇痛前和宫口全开时血清疼痛介质P物质(SP)、β-内啡肽(β-Ep)水平、不良反应发生率及新生儿体重和新生儿Apgar评分。结果与对照组比较,试验组T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时期VAS评分低(P<0.05);两组产程时间对比差异无统计学意义(P>0.05);与对照组比较,试验组自控镇痛次数少(P<0.05);与对照组比较,试验组宫口全开时SP、β-Ep水平低(P<0.05);试验组不良反应发生率与对照组对比差异无统计学意义(P>0.05);两组新生儿体重和新生儿Apgar评分对比差异无统计学意义(P>0.05)。结论罗哌卡因联合纳布啡PIEB应用于阴道分娩产妇中,可缓解疼痛症状,减少自控镇痛次数,降低产妇应激反应,且不良反应少,对新生儿结局无明显影响。
Objective To study the application effect of ropivacaine combined with nalbuphine programmed intermittent epidural bolus(PIEB)in women with vaginal delivery.Methods A total of 82 cases of parturient women with vaginal delivery in Xinxiang Maternal and Child Health Hospital from January 2022 to January 2023 were selected and divided into the control group(41 cases)and experimental group(41 cases)by random number table method.The control group received ropivacaine PIEB,and the experimental group received ropivacaine combined with nalbuphine PIEB.The visual simulation score(VAS)was compared between the two groups at different time periods[before labor analgesia(T_(0)),30 minutes after analgesia(T_(1)),1 hour after analgesia(T_(2)),2 hours after analgesia(T_(3)),the time of uterine full opening(T_(4)),during labor(T_(5))].Labor time and frequency of controlled analgesia were compared between the two groups.The levels of serum pain mediator substance P(SP),β-Endorphin(β-Ep),incidence of adverse reactions,neonatal weight and neonatal Apgar score were compared between the two groups before labor analgesia and at the time of uterine full opening.Results Compared with the control group,VAS scores at T_(1),T_(2),T_(3),T_(4)and T_(5)in the experimental group were lower(P<0.05).There was no significant difference in labor time between the two groups(P>0.05).Compared with the control group,the number of controlled analgesia in the experimental group was less(P<0.05).Compared with the control group,the levels of SP andβ-Ep in the experimental group were lower at the time of uterine full opening(P<0.05).There was no significant difference in the incidence of adverse reactions between the experimental group and the control group(P>0.05).There were no significant differences in neonatal body weight and Apgar score between the two groups(P>0.05).Conclusion Ropivacaine combined with nalbuphine PIEB can relieve pain symptoms,reduce the number of self-controlled analgesia,reduce maternal stress response,with fewer adverse reaction
作者
宋秀荣
范静伟
刘艳敏
SONG Xiurong;FAN Jingwei;LIU Yanmin(Department of Anesthesia,Xinxiang Maternal and Child Health Hospital,Xinxiang 453000,China)
出处
《河南医学研究》
CAS
2024年第4期708-711,共4页
Henan Medical Research
关键词
阴道分娩
罗哌卡因
纳布啡
硬膜外间歇脉冲式注射
vaginal delivery
ropivacaine
nalbuphine
epidural intermittent pulse injection
