罗哌卡因及舒芬太尼不同硬膜外分娩镇痛方案对产后尿潴留的影响
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湖南省自然科学基金(No:2016JJ6052)


Effect of different epidural labor analgesia regimens with Ropivacaine and Sufentanil on postpartum urinary retention
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    摘要:

    探讨不同硬膜外分娩镇痛方案对产后尿潴留的影响。方法 选取 2016 年 1 月 -2016 年 9 月该院拟硬膜外分娩镇痛下自然分娩产妇 76 例。按照数字表法随机分为两组:A 组患者给予 0.1%罗哌卡因 +0.3μg/ml 舒芬太尼,B 组 0.075%罗哌卡因 +0.5μg/ml 舒芬太尼。两组患者均于宫口开放 3 cm 时经 L 3 -L 4 间隙行硬膜外穿刺置管行分娩镇痛。记录产妇行分娩镇痛后视觉模拟评分(VAS)、下肢肌力、尿潴留及新生儿出生后 Apgar 评分。结果 两组产妇分娩镇痛后各时间点 VAS 评分 <4,组间差异无统计学意义( >0.05)。两组患者均未出现明显双下肢肌力减退。两组新生儿出生后 Apgar 评分差异无统计学意义( >0.05)。产后 6 h A 组出现 2 例产后尿潴留,B 组出现 8 例,组间差异有统计学意义( <0.05)。产后 24 h 两组患者均未发现明显尿潴留。结论 硬膜外给予 0.1%罗哌卡因 +0.3μg/ml 舒芬太尼或 0.075%罗哌卡因 +0.5μg/ml 舒芬太尼均可有效缓解产妇分娩疼痛,但前者产后尿潴留比例更低。

    Abstract:

    To observe the effect of different epidural labor analgesia methods with Ropivacaine and Sufentanilon postpartum urinary retention(PUR).Methods Totally 76 pregnant women undergoing vaginal childbirth with epidural labor analgesia were randomly divided into two groups,i.e.group A (using 0.1% Ropivacaine and 0.3 μg/ml Sufentanil)and group B (using0.075% Ropivacaine and 0.5 μg/ml Sufentanil).In all th epatients epidural catheters were placed into L3-L4 epidural space at 3-cm cervical dilation forinfusion of the analgesics.The Visual Analogue Scale(VAS),the Rating Scale for Muscle Strength of the legs,PUR of the delivery women and the Apgar scores of the infants were recorded.Results The VAS score after epidural labor analgesia was less than 4 in all of patients,but there was no difference between the two groups( p> 0.05).Muscle weakness was not observed in any delivery woman.There were no significant differences in the Apgarscores of the infant between the two groups(p >0.05).PUR was observed in 2 patients of the group A and 8 patients of the group B 6 hours after childbirth ( p<0.05),but not observed 24 hours after childbirth.Conclusions Epidural administration of 0.1% Ropivacaine plus 0.3 μg/ml Sufentanil or 0.075% Ropivacaine plus0.5 μg/ml Sufentanil can effectively relieve pain of labor,but the risk of PUR is lower with the former analgesic regimen.

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张洁,李爱媛.罗哌卡因及舒芬太尼不同硬膜外分娩镇痛方案对产后尿潴留的影响[J].中国现代医学杂志,2017,(10):76-79

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  • 收稿日期:2016-12-25
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  • 在线发布日期: 2017-05-31
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