| 霍奇帆,蒋延安,李 扬,张世平,赵 静.羟考酮、舒芬太尼与罗哌卡因对分娩镇痛效果的对比影响分析[J].,2021,(21):4147-4151 |
| 羟考酮、舒芬太尼与罗哌卡因对分娩镇痛效果的对比影响分析 |
| Analysis of the Effects of Oxycodone, Sufentanil and Ropivacaine on Epidural Labor Analgesia |
| 投稿时间：2021-01-31 修订日期：2021-02-27 |
| DOI：10.13241/j.cnki.pmb.2021.21.031 |
| 中文关键词: 羟考酮、舒芬太尼、分娩镇痛、皮质醇、一氧化氮 |
| 英文关键词: Oxycodone Sufentanil Labor analgesia Cortisol Nitric oxide |
| 基金项目:陕西省自然科学基础研究项目（2018JM-661） |
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| 中文摘要: |
| 摘要 目的：比较羟考酮、舒芬太尼用于分娩硬膜外自控镇痛（patient epidural controlled analgesia，PCEA）后的镇痛效果及安全性。方法：选择美国麻醉师协会（american society of anesthesiologists，ASA）Ⅰ～Ⅱ级的初产妇210名，随机分为3组，羟考酮(O)组采用0.1 %罗哌卡因复合羟考酮硬膜外镇痛、舒芬太尼（S）组采用0.1 %罗哌卡因复合舒芬太尼硬膜外镇痛，罗哌卡因（C）组采用0.1 %罗哌卡因硬膜外镇痛，每组70例。记录患者入室（T0）、首剂量给予10 min（T1）、30 min(T2)、宫口全开（T3）时的血流动力学指标、视觉模拟评分法（visual analog scales，VAS）评分，分娩镇痛起效时间，作用持续时间、产程时间和出生后1 min、5 min 新生儿Apgar 评分。分别抽取T0、T2产妇静脉血及新生儿娩出（T4）后静脉血，分别检测血清皮质醇以及一氧化氮（nitric oxide，NO）浓度。结果：实施分娩镇痛的产妇疼痛缓解，O组、S组与C组在相应时间点VAS评分差异有统计学意义（P＜0.05），S组起效时间快于O组、C组，O组持续时间长于S组、C组（P＜0.05）。S组、C组较O组NO浓度显著降低，O组较S组、C组皮质醇浓度显著降低（P＜0.05）。三组产妇生命体征平稳，产程时间、新生儿Apgar评分无明显差别（P>0.05）。结论：羟考酮起效时间快，镇痛时间长，可延缓母婴NO降低时间，降低皮质醇浓度，降低产妇的应激反应且镇痛效果优于舒芬太尼及罗哌卡因。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effect and safety of oxycodone and sufentanil after delivery epidural controlled analgesia (PCEA). Methods: Choose ASA level Ⅰ～Ⅱ primipara 210, were randomly divided into 3 groups. The oxycodone (O) group was treated with 0.1% ropivacaine combined with oxycodone, the sufentanil (S) group was treated with 0.1 % ropivacaine combined with sufentanil, and the ropivacaine (C) group was treated with 0.1 % ropivacaine epidural analgesia, 70 cases in each group. Record the hemodynamic indexes and VAS scores when the patients entered the room (T0), were given the first dose for 10 min (T1), 30 min (T2), and cervix were open (T3), the labor analgesia onset time, duration of analgesia, labor duration and Apgar score of newborns 1 and 5 min after birth. Venous blood of T0 and T2 mothers and newborn babies after delivery (T4) were extracted, and serum cortisol and NO concentrations were tested respectively. Results: Maternal pain relief from delivery analgesia, the VAS scores of group O, group S and group C showed statistically significant differences at corresponding time points(P<0.05), the onset time of group S was faster than that of group O and group C, and the duration of group O was longer than that of group S and group C(P<0.05). The concentration of NO in group S and group C was significantly lower than that in group O, and the concentration of cortisol in group O was significantly lower than that in group S and group C(P<0.05). The vital signs of the three groups were stable, and there was no significant difference in labor time or newborn Apgar score(P>0.05). Conclusion: Oxycodone has a fast onset time and a long analgesic time, which can delay the decrease of NO in infants and mothers, reduce the concentration of cortisol, and reduce the maternal stress response, and the analgesic effect is better than sufentanil and ropivacaine. |
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