南方医科大学学报 ›› 2018, Vol. 38 ›› Issue (04): 502-.

• • 上一篇    

穴位注射罗哌卡因的分娩镇痛效果及其对产妇皮质醇水平的影响

陈祥楠,杨世辉,林辉瑞,陈宁宁,苏晨露,黄薇   

  • 出版日期:2018-04-20 发布日期:2018-04-20

Efficacy of ropivacaine injection at acupoints for labor analgesia and its effect on cortisol level in parturients

  • Online:2018-04-20 Published:2018-04-20

摘要: 目的评价合谷穴、三阴交穴注射罗哌卡因分娩镇痛效果及其对产妇皮质醇水平的影响。方法选取ASA I-Ⅱ级、单胎、足 月(≥37周,<41周)、枕前位妊娠拟阴道产,自愿要求穴位分娩镇痛的初产妇120例,随机分为研究组(A组)、对照组(B组)。在宫口 开至≥3 cm 时,A组在双侧三阴交穴、合谷穴注入0.2%罗哌卡因1 mL;B组在双侧三阴交穴、合谷穴注入0.9%生理盐水1 mL。 比较两组产妇镇痛前、镇痛后30、60、120 min的视觉模拟评分(VAS评分);比较两组各产程时间、分娩结局、皮质醇浓度等指 标。结果研究组产妇镇痛后VAS 评分均较镇痛前及对照组均明显降低(P<0.05);镇痛2 h后,对照组产妇血清皮质醇浓度显 著高于研究组(P<0.05);两组中转剖宫产率、器械助产率、各产程时间无统计学差异(P>0.05)。结论合谷穴、三阴交穴注射罗 哌卡因分娩镇痛具有良好的镇痛效果,不会延长产程,不会增加剖宫产率、器械助产率。

Abstract: Objective To evaluate the efficacy of ropivacaine injection at the acupoints Hegu and Sanyinjiao for labor analgesia and its effects on cortisol level in parturients. Methods A total of 120 ASA class I- II nulliparous women undergoing spontaneous term labor (37 to 41 weeks of gestation) with a live, singleton fetus in the occiput anterior position and requiring labor analgesia with acupuncture were enrolled in this study. These women were randomized into study group and control group and received injections of 1 mL of 0.2% ropivacaine and normal saline, respectively, at each of the acupoints of bilateral Sanyinjiao and Hegu in the first stage of labor. The Visual Analogue Scale (VAS) before and at 30, 60 and 120 min after analgesia, the time of labor, delivery outcome and cortisol levels were compared between the two groups. Results The VAS was significantly lower in the study group than in the control group (P<0.05). At 120 min after injections of ropivacaine or saline, serum cortisol level was significantly higher in the control group than in the study group (P<0.05). The rates of cesarean section and instrumental delivery and the time of labor were all similar between the two groups (P>0.05). Conclusion Ropivacaine injection at Hegu and Sanyinjiao is effective for labor analgesia and does not prolong the process of labor or increase the rates of cesarean section or instrumental delivery.