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目的:探讨产妇分娩应用罗哌卡因复合舒芬太尼椎管内阻滞麻醉的镇痛效果以及对母婴的影响。方法:选择于2013年12月至2014年12月于连南瑶族自治县人民医院分娩的产妇170例,根据镇痛方式的不同分为观察组和对照组,每组85例,观察组采用罗哌卡因复合舒芬太尼椎管内阻滞麻醉镇痛,对照组不用麻醉药物,自然分娩,比较两组在镇痛前、镇痛后10 min、20 min等时间点的疼痛VAS评分,对产妇及婴儿进行桡动脉、脐动脉血气分析,随访1年,评估婴儿智力及运动能力。结果:(1)麻醉前,两组VAS评分并无差异,麻醉10 min后及各时间点,观察组的VAS评分均显著低于对照组,差异具有统计学意义(P<0.05);(2)观察组产妇及婴儿的血pH值均明显高于对照组,PaCO_2和PaO_2明显低于对照组,差异具有统计学意义(P<0.05);(3)随访1年,两组婴儿的运动及智力水平差异无统计学意义(P>0.05)。结论:产妇分娩应用罗哌卡因复合舒芬太尼椎管内阻滞麻醉具有良好的镇痛效果,且对婴儿发育无不良影响。
Objective: To investigate the analgesic effect of maternal anesthesia with ropivacaine and sufentanil combined with maternal anesthesia in maternal labor and its effects on maternal and infant. Methods: A total of 170 maternal women who gave birth in Liannan Yao Autonomous County People’s Hospital from December 2013 to December 2014 were selected and divided into observation group and control group according to the mode of analgesia. Each group was treated with ropivacaine Caesarean sufentanil spinal anesthesia analgesia, the control group without anesthesia, natural childbirth, pain relief in the two groups before analgesia, analgesia 10 min, 20 min and other time points pain VAS score, Maternal and infant radial artery, umbilical artery blood gas analysis, followed up for 1 year to assess the infant’s intelligence and exercise capacity. Results: (1) There was no difference in VAS score between the two groups before anesthesia. The VAS score of the observation group was significantly lower than that of the control group at 10 min after anesthesia and at various time points (P <0.05) (P <0.05); (3) The follow-up of 1 year, the movement of the two groups of infants and the difference of the PaCO 2 and PaO 2 levels between the two groups were statistically significant There was no significant difference in intelligence level (P> 0.05). Conclusion: Maternal delivery of ropivacaine combined with sufentanil for spinal block anesthesia has a good analgesic effect and has no adverse effect on infant development.