右美托咪定-罗哌卡因与舒芬太尼-罗哌卡因对硬膜外分娩镇痛的疗效和安全性：一项随机对照试验

以下文章来源于罂粟花 ，作者anesthGH

本文由“罂粟花”授权转载

右美托咪定-罗哌卡因与舒芬太尼-罗哌卡因对硬膜外分娩镇痛的疗效和安全性：一项随机对照试验

贵州医科大学    麻醉与心脏电生理课题组

翻译：严旭

编辑：宋雨婷

审校：曹莹

1背景

舒芬太尼与罗哌卡因的复合麻醉通常用于硬膜外分娩镇痛，但它可能会引起一些不良反应。右美托咪定适用于长期和短期术中镇静和镇痛，它可以减少阿片类药物舒芬太尼的使用。这项研究比较了右美托咪定和舒芬太尼与罗哌卡因复合用于硬膜外分娩镇痛的疗效和安全性。

2方法

对硬膜外分娩镇痛进行随机、三盲、对照试验。从2020年10月到2021年2月，所有产妇都通过计算机随机1:1接受罗哌卡因+右美托咪定复合麻醉组（RD组）和罗哌卡因+舒芬太尼复合麻醉组（RS组）。主要指标是通过视觉模拟量表（VAS）评分评估产妇的疼痛，以及通过新生儿行为神经评估（NBNA）评分和Apgar评分评估的新生儿的身体状况。次要指标包括分娩阶段的持续时间以及产妇和新生儿的不良反应。

3结果

这项研究共包括160名产妇，每组80人。注射止痛药后，两组的VAS评分都较低（在120分钟内；RD：2.6±1.0比RS：2.5±0.8；P =0.489），并且没有显著差异。新生儿的NBNA（RD：39.9±0.4比RS：39.8±0.5；P =0.368）和Apgar评分（RD：9.8±0.7比RS：9.7±0.8；P =0.424）高于正常标准（NBNA>37；Apgar>7），也没有显著差异。在两组之间，产妇统计学特征、生命体征、拉姆齐镇静量表（RSS）数值、失血、分娩持续时间（第一和第二阶段）、镇痛开始时间和镇痛药物剂量方面没有发现差异（均为P >0.05）。两组产妇和新生儿的不良反应发生率都较低。

4结论

右美托咪定或舒芬太尼与罗哌卡因复合用于硬膜外分娩镇痛，在临床实践中具有类似的镇痛作用。

原始文献来源：

Mei Fan, Juan Li , Rong Cao,Efficacy and safety of dexmedetomidine-ropivacaine versus sufentanil-ropivacaine for epidural labor analgesia: a randomized controlled trial[J].nn Palliat Med. 2022 Apr;11(4):1410-1420.

英文原文

Efficacy and safety of dexmedetomidine-ropivacaine versus sufentanil-ropivacaine for epidural labor analgesia: a randomized controlled trial

Background: Sufentanil combined with ropivacaine is commonly used for epidural labor analgesia, but it may cause some adverse effects. Dexmedetomidine is suitable for long-term and short-term intraoperative sedation and analgesia, and it can reduce the use of the opioid sufentanil. This study compared the efficacy and safety of dexmedetomidine and sufentanil combined with ropivacaine for epidural labor analgesia.

Methods: A randomized, triple-blinded, controlled trial was performed for epidural labor analgesia. All included parturient women were randomized 1:1 by computer to receive ropivacaine combined with dexmedetomidine (group RD) or sufentanil (group RS) from October 2020 to February 2021. The primary outcomes were the pain relief of parturient women assessed by the visual analog scale (VAS) score, and the physical status of newborns assessed by the neonatal behavioral neurological assessment (NBNA) score and Apgar score. Secondary outcomes included the duration of labor stages and adverse reactions of parturient women and newborns.

Results: A total of 160 parturient women were included in this study, with 80 in each group. The VAS scores were lower in both groups after the injection of analgesics (in 120 min; RD: 2.6±1.0 vs. RS: 2.5±0.8; P=0.489), and there was no significant difference. The newborns' NBNA (RD: 39.9±0.4 vs. RS: 39.8±0.5; P=0.368) and Apgar scores (RD: 9.8±0.7 vs. RS: 9.7±0.8; P=0.424) were higher than normal standard (NBNA >37; Apgar >7) in both groups, and there were also no significant differences. No differences in parturient women's demographic characteristics, vital signs, Ramsay Sedation Scale (RSS) values, blood loss, duration of labor stages (first and second stages), onset time of analgesia, and dose of analgesics were found between the 2 groups (all P>0.05). The incidence of adverse reactions in parturient women and newborns was low in both groups.

Conclusions: Dexmedetomidine or sufentanil combined with ropivacaine for epidural labor analgesia had similar analgesic effects in clinical practice.

-END-

免责声明：

本公众平台所刊载原创或转载内容不代表米勒之声的观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供医学专业人士参考。

END

编辑：MiLu.米鹭

校对：Michel.米萱

打赏