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1、舒芬太尼与芬太尼用于硬膜外阻滞分娩镇痛中的临床比较董经纬徐铭军岳剑宁首都医科大学附属北京妇产医院麻醉科【摘耍】目的:比较舒芬太尼与芬太尼用于分娩镇痛的镇痛效果、对产程、母婴的影响及其副作用。方法:自然分娩足月初产妇120例,年龄25-28岁,ASAI级,分为3组:镇痛药物S组:0.5ug/ml舒芬太尼+0.15%罗哌卡因;F组:2ug/ml芬太尼+0.15%罗哌卡因;C组:对照组,未用任何镇痛方法。观察镇痛组硬膜外给药前及给药lOmin,30min,60min,120min,180minVAS评分,首次加药吋间、宫口开大程度、宫缩频率、分娩方式、产后出血量、催产素使用情况、新生儿Apgar
2、评分等。结果:与C组比较,S组和F组产妇镇痛效果满意(P&t;0.05)oS组和F组各时点VAS评分差异无统计学意义(p>0.05)。三组间产程时间、宫缩频率、宫缩持续时间、分娩方式、产后出血量、催产素使用量、新生儿窒息发生率、剖宫产率及运动神经的阻滞差异无统计学意义(P>0.05),但舒芬太尼有使第一产程缩短的趋势。宫口开大程度及VAS评分三组在所有时点差异有统计学意义(P<0.05)o结论:舒芬太尼用于硬膜外阻滞分娩镇痛能提供良好的镇痛效果,缩短活跃期产程,对母婴均无不良影响。【关键词】舒芬太尼;芬太尼;硬膜外麻醉;分娩镇痛AStudytoSufentanilbeUs
3、edinEpiduralAnesthesiaforLaborAnalgesiaDONGJing一wetXUMing一JanYUEPan一ping.DepartmentofAnesthesiology,BeijingobstestricandgynecologichospitalaffiliatedtocapitalmedicaluniversityBeijing,100026[Abstract】Objective:Toevaluatelaboranalgesiaeffectandsafetyofepiduralanesthesiawithsufentanilascomparedwithfe
4、ntanyl.Methods:OnehimdredandtwentyASAIfulltermprimiparaswhowere25一28yearsoldandhadasinglefetuswereexpectedtohaveavaginaldeliverywererandomlydividedinto3groups:groupS(n=40),0.5ug/mlsufentanil+0.15%ropivacaine,groupsF(n=40),2ug/mlfentany1+0.15%ropivacaine,groupC(n二40),receivednoanalgesia・TheVASscore
5、,firstinjectdrugtime,cervixdilation,uterinecontractfrequency,modeofdelivery,postpartumhemorrhage,amountofoxytocinrequiredandApgarscoreofneonateswererecorded.Results:ComparedtogroupC,GroupSandGroupFhadmoreanalgesiasatisfactory(P<0.05).GroupSandGroupFwerenodiffereneeinVASscore(P>0.05).'therewa
6、snosigrdficantdiffereneeinbrithprocesstime,uterinecontractfrequency,uterinecontractduratior^modeofdelivery,postpartumhemorrhage,amountofoxytocinrequired,rateofneonataIasphyxiaandcesareansection,degreeofmotorblock(P>0.05).TherewasfirststageoflaborshortenedtendencywithGroupS.ThecervixdilationandV
7、ASscoreamongthreegroupsweresignificantdifference(P<0.05).Conclusion:Epiduralanesthesiawithsufentaniliseffectiveandsafetyforlaboranalgesia,theactivestageoflaborcanbeshortened.[Keywords]Sufentanil,Fentanyl,Epidu