摘要
目的探究罗哌卡因联合利多卡因对椎管内分娩镇痛下自然分娩初产妇会阴疼痛及泌乳情况的影响。方法回顾性分析2019年1月至2020年12月本院收治的152例椎管内分娩镇痛下自然分娩初产妇,根据麻醉方法不同将其分为参照组和观察组,各76例。参照组给予利多卡因浸润麻醉,观察组给予罗哌卡因联合利多卡因浸润麻醉。比较两组的疼痛程度、不良反应发生情况、产程、性激素水平、应激反应相关激素水平、满意度评分、泌乳始动时间及泌乳量。结果浸润麻醉后10 min、浸润麻醉后30 min、宫口全开、胎儿娩出时,观察组的视觉模拟评分法(VAS)评分低于参照组,差异具有统计学意义(P<0.05)。两组产妇的不良反应总发生率比较,差异无统计学意义(P>0.05)。观察组的第一、二、三产程短于参照组,差异具有统计学意义(P<0.05)。分娩后30 min,两组的黄体生成素(LH)、卵泡刺激素(FSH)、孕酮(P)水平升高,雌二醇(E_(2))水平降低,且观察组优于参照组,差异具有统计学意义(P<0.05)。分娩后30 min,两组的肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(COR)、肾上腺皮质激素(ACTH)水平均降低,且观察组低于参照组,差异具有统计学意义(P<0.05)。观察组的满意度评分及产后48 h泌乳量高于参照组,泌乳始动时间早于参照组,差异具有统计学意义(P<0.05)。结论罗哌卡因联合利多卡因浸润麻醉可提升椎管内分娩镇痛下自然分娩初产妇的镇痛效果、加快产程、改善产后泌乳量、提高产后康复效果,调节性激素及应激反应相关激素水平,值得临床推广应用。
Objective To explore the effects of ropivacaine combined with lidocaine on perineal pain and lactation situation in primipara with natural childbirth under intraspinal labor analgesia.Methods A total of 152 primipara with natural childbirth under intraspinal labor analgesia admitted in our hospital from January 2019 to December 2020 were retrospectively analyzed and divided into reference group and observation group according to different anesthesia,with 76 cases in each group.The reference group was given lidocaine infiltration anesthesia,and the observation group was given ropivacaine combined with lidocaine infiltration anesthesia.The pain intensity,occurrence of adverse reactions,birth process,sex hormone levels,stress response related hormone levels,satisfaction score,initial time of lactation and lactation yield were compared between the two groups.Results At 10 min after infiltration anesthesia,30 min after infiltration anesthesia,miyako fully openthe and fetal disengagement,the Visual Analogue Score(VAS)score in the observation group was lower than that in the reference group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).The first,second and third birth process in the observation group were shorter than those in the reference group,and the differences were statistically significant(P<0.05).At 30 min after childbirth,the levels of luteinizing hormone(LH),follicle stimulating hormone(FSH)and progesterone(P)in the two groups increased,the level of estradiol(E_(2))decreased,those in the observation group were better than the reference group,and the differences were statistically significant(P<0.05).At 30 min after childbirth,the levels of epinephrine(E),norepinephrine(NE),cortisol(COR)and adrenal cortical hormone(ACTH)in the two groups decreased,those in the observation group were lower than the reference group,and the differences were statistically significant(P<0.05).The satisfaction score and lactation yield at 48 h postpartum in the observation group were higher than those in the reference group,the initial time of lactation was earlier than that in the reference group,and the differences were statistically significant(P<0.05).Conclusion Ropivacaine combined with lidocaine infiltration anesthesia can improve the analgesic effect of primipara with natural childbirth under intraspinal labor analgesia,accelerate labor process,ameliorate postpartum lactation yield,improve the effect of postpartum rehabilitation,regulate the levels of sex hormones and stress response related hormones,which is worthy of clinical promotion and application.
作者
吴永康
朱崇军
WU Yongkang;ZHU Chongjun(Xi'an No.5 Hospital,Xi'an 710082,China)
出处
《临床医学研究与实践》
2022年第36期160-163,共4页
Clinical Research and Practice
关键词
罗哌卡因
利多卡因
椎管内分娩镇痛
自然分娩
初产妇
泌乳
ropivacaine
lidocaine
intraspinal labor analgesia
natural childbirth
primipara
lactation
