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目的:观察鞘内不同剂量舒芬太尼复合罗哌卡因在腰硬联合阻滞分娩镇痛的效果,拟筛选出国人分娩镇痛最佳剂量。方法:选择初产妇180例,随机分6组,单纯药物组(S3和R3组)和复合药物组(S2R2、S2R3、S3R2和S3R3组),双盲对照观察。各组均采用蛛网膜下腔给药后硬膜外腔留管产妇自控镇痛(CSE+PCA),各组的硬膜外维持用药相同。观察记录镇痛起效时间、不同时间的VAS评分、镇痛维持时间、运动阻滞、各组产程、出血量、新生儿1min和5min Apgar评分、镇痛满意度、剖宫产率、不良反应等指标。结果:镇痛起效时间复合药物组小于单纯药物组(P<0.05);复合药物组在各时间点的镇痛效果和镇痛满意度均优于单纯药物组,镇痛维持时间明显长于单纯药物组(P<0.05)。结论:2～3μg舒芬太尼复合2～3mg罗哌卡因鞘内给药可提供安全、有效的分娩镇痛效果,尤以3μg舒芬太尼复合2～3mg罗哌卡因效果更佳。
Objective: To observe the effects of different doses of sufentanil combined with ropivacaine on analgesia induced by block of waist and abdomen, and to select the best dose of analgesia for labor among Chinese people. Methods: 180 primiparae were randomly divided into 6 groups: simple drug group (group S3 and group R3) and compound drug group (group S2R2, group S2R3, group S3R2 and group S3R3). Epidural analgesia (CSE + PCA) was used in all groups after subarachnoid administration. Epidural maintenance was the same in all groups. The time of onset of analgesia, the VAS score, the duration of analgesia, the block of movement, the duration of labor, the amount of bleeding in each group, the Apgar score at 1 minute and 5 minutes, satisfaction rate of analgesia, cesarean section rate, adverse reactions And other indicators. Results: The analgesic onset time in the composite drug group was smaller than that in the pure drug group (P <0.05). The analgesic effect and analgesic satisfaction of the composite drug group were better than the simple drug group at each time point, and the analgesic maintenance time was significantly longer than that of pure drug group Drug group (P <0.05). Conclusion: Intramuscular administration of 2 ~ 3μg sufentanil 2 ~ 3mg ropivacaine can provide a safe and effective labor analgesia, especially 3μg sufentanil 2 ~ 3mg ropivacaine is more effective .