小剂量罗哌卡因复合舒芬太尼硬膜外麻醉对高龄产妇分娩镇痛效果评估

目的:评估小剂量罗哌卡因复合舒芬太尼硬膜外麻醉对高龄产妇分娩镇痛效果。方法:选取我院2019年1月-2020年12月共收治的80例高龄无痛分娩产妇作为研究对象,对照组产妇应用罗哌卡因进行硬膜外麻醉;观察组产妇应用小剂量罗哌卡因复合舒芬太尼硬膜外麻醉,对比两组镇痛效果、VAS评分、Bromage评分、自控镇痛追加次数、产程时间、24 h的新生儿窒息情况与24 h泌乳量评分情况。结果:观察组镇痛效果明显优于对照组(P<0.05);观察组产妇的VAS评分在三个产程时间内评分明较对照组低(P<0.05);观察组产妇第一产程和第二产程的Bromage评分略低于对照组,但对比差异不显著(P>0.05),第三产程观察组的Bromage评分明显较对照组低;观察组产妇的自控镇痛追加次数较对照组低(P<0.05);观察组的第一产程和第二产程时间明显低于对照组(P<0.05);观察组产妇产后24 h泌乳量评分优于对照组(P<0.05);观察组新生儿窒息比例略低于对照组,但是并无显著差异(P>0.05)。结论:对高龄产妇分娩应用小剂量罗哌卡因复合舒芬太尼硬膜外麻醉镇痛效果显著,镇痛追加药剂量少,产程时间短,安全有效,有利于产妇产后分泌母乳,值得临床应用推广。

Effect of Low Dose Ropivacaine Combined with Sufentanil Epidural Anesthesia on Labor Analgesia in Elderly Women

Objective:To evaluate the effect of low-dose ropivacaine combined with sufentanil epidural anesthesia on labor analgesia in elderly women.Methods:80 elderly painless parturients admitted to our hospital from January 2019 to December 2020 were selected as the study objects.The control group was given ropivacaine for epidural anesthesia;the observation group was given low-dose ropivacaine combined with sufentanil for epidural anesthesia.The analgesic effect,VAS score,Bromage score,additional times of PCEA,duration of labor,the asphyxia and 24-hour lactation score of the newborn at 4 hours were compared between the two groups.Results:The analgesic effect of the observation group was significantly better than that of the control group,the difference was not significant(P>0.05),the Bromage score of the third labor process was different in the two groups(P>0.05);the Bromage scores of the first and second stages of labor in the observation group were slightly lower than those in the control group,but the difference was not significant(P>0.05).the additional times of PCEA in the observation group was significantly lower than that of the control group(P<0.05);the time of the first labor process and the second labor process was different in the two groups(P<0.05).The score of 24 h postpartum lactation in the observation group was compared with the control group(P<0.05).The proportion was slightly lower than that of the control group,but there was no significant difference(P>0.05).Conclusion:Low dose ropivacaine combined with sufentanil is effective in epidural analgesia for the elderly parturient.It is safe and effective for the parturient to secrete breast milk after childbirth.It is worthy of clinical application.