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目的探讨舒芬太尼与舒芬太尼混合罗哌卡因用于腰硬联合阻滞分娩镇痛的临床效果。方法选择初产妇60例,分两组,6μg舒芬太尼组(S6组)和3μg舒芬太尼混合3mg罗哌卡因组(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),且各组的硬膜外腔维持用药相同。观察记录镇痛起效时间、镇痛维持时间、不同时间的VAS评分、运动阻滞、各组产程、出血量、新生Apgar评分、镇痛满意度、不良反应等指标。结果镇痛起效时间S3R3组小于S6组(P<0.05);镇痛维持时间S3R3长于S6组(P<0.05),蛛网膜下腔给药140min后镇痛评分S3R3组优于S6组(P<0.05);皮肤瘙痒及恶心呕吐发生率S3R3组低于S6组(P<0.05)。结论6μg舒芬太尼或3μg舒芬太尼混合3mg罗哌卡因蛛网膜下腔给药分娩镇痛效果确切,对产妇和新生儿无不良影响。3μg舒芬太尼混合3mg罗哌卡因珠蛛网膜下腔给药分娩镇痛效果优于6μg舒芬太尼。
Objective To investigate the clinical effect of sufentanil mixed with sufentanil combined with ropivacaine in the analgesia of labor and waist joint. Methods Sixty primipara were selected and divided into two groups, 6μg sufentanil group (S6 group) and 3μg sufentanil mixed with 3mg ropivacaine group (S3R3 group). Double-blind controlled observation. Epidural catheterization and maternal controlled analgesia (CSE + PCA) were used in all the groups. The epidural space was maintained in the same group. Observe and record analgesic onset time, analgesic maintenance time, VAS score at different times, motor block, each group of labor, bleeding, neonatal Apgar score, analgesic satisfaction, adverse reactions and other indicators. Results The onset time of analgesia in S3R3 group was smaller than that in S6 group (P <0.05). The duration of analgesic maintenance was longer in S3R3 group than in S6 group (P <0.05). After 140 minutes of subarachnoid administration, analgesia score was better in S3R3 group than in S6 group <0.05). The incidence of skin pruritus and nausea and vomiting were lower in S3R3 group than in S6 group (P <0.05). Conclusion 6μg sufentanil or 3μg sufentanil mixed 3mg ropivacaine subarachnoid administration analgesia with exact labor, no adverse effects on mothers and newborns. 3μg sufentanil mixed 3mg ropivacaine beads subarachnoid administration of labor analgesia better than 6μg sufentanil.