Efficency comparison of Remifentanil analgesia and Sufentani combined with Ropivacaine analgesia in labor
ZHANG Xiao-hua1 LI Xi-rong2
1.Department of Anesthesiology,Maoming Hospital of Triditional Chinese Medicine Affiliated to Guangzhou University of Triditional Chinese Medicine in Guangdong Province,Maoming 525000,China;
2.Department of Laboratory,Maoming Hospital of Triditional Chinese Medicine Affiliated to Guangzhou University of Triditional Chinese Medicine in Guangdong Province,Maoming 525000,China
ObjectiveTo compare the safety and feasibility of Remifentanil parturient-controlled intravenous analgesia (PCIA)and Sufentani combined Ropivacaine parturient-controlled epidural analgesia(PCEA)in labor.MethodsFrom January 2013 to December 2014,246 cases of pregnant women who were full-term pregnancy suitable for vaginal trial delivery and head position single pregnancy healthy primipara,ASAⅠ-Ⅱ,were received：labor analgesia.They were randomly divided into PCIA and PCEA group,with 123 cases in each group.When the uterus cervix opened to 4 cm,PCIA group were given intravenous Remifentanil,the loading dose was 0.02 μg/ml,the maintenance dose was 0.04 μg/(kg·min), PCA dose was 0.4 μg/kg and the locking time of analgesic pump was 3 min.While PCEA group were given Sufentanil 0.4 μg/ml+0.1%Ropivacaine by epidural catheter,the loading dose and maintenance dose were 5-6 ml/h,the PCA dose was 6 ml,and the locking time of analgesic pump was 30 min.Analgesia was stopped when uterine orifice fully open and continued when the perineum incision was sutured.Visual analogue scale(VAS)score before analgesia(T0),1,2,3 h(T1,T2, T3)after analgesia of two groups were observed and the labor time,delivery mode,neonatal Apgar score andadverse reactions of two groups were recorded.ResultsVAS score of PCEA group was obviously lower than PCIA group at T1,T2,T3,(P<0.05).there were no statistically significant difference between two groups in eutocous rate,1abor process, the period of first,second,and third stage of labor,forceps delivery rate,cesarean section rate and the rate of using of oxytocin,neonatal Apgar score,and incidences of vomiting and pruritus(P>0.05);there had a significantly higher incidence of dizziness in PCIA group than in PCEA group,but the incidence of lower limb numbness in PCIA group was significantly lower than in PCEA group,the difference was statistically significant(P<0.05).ConclusionRemifentanil PCIA is not so effective as Sufentanil combined Ropivacaine PCEA,but it is easy operation,less trauma,quick onset.So Remifentanil PCIA can be used under the precondition of ensuring to monitor the maternal and fetal when the maternal especially has contraindication of intraspinal block,fear of intra-spinal canal puncture and anesthesia position incompatibility．
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