Comparison of the efficacy and safety between the use of ropivacaine alone and ropivacaine with sufentanil in epidural labor analgesia
- VernacularTitle:单纯罗哌卡因与罗哌卡因复合舒芬太尼在硬膜外分娩镇痛中的比较
- Author:
Xian WANG
;
Fan XIA
;
Shanwu FENG
;
Shiqin XU
;
Xiaofeng SHEN
- Publication Type:Journal Article
- Keywords:
Ropivacaine;
Ropivacaine combined with sufentanil;
Efficacy;
Safety
- From:
The Journal of Clinical Anesthesiology
2016;32(8):761-764
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the analgesic efficacy and safety of the sole local anesthetic ropivacaine with the combination of both local anesthetic ropivacaine and opioidergic analgesic sufen-tanil given epidurally on the labor pain control.Methods After institutional review board approval and patient consent,a total of 481 nulliparas requesting epidural labor analgesia were randomized into two groups:a sole local anesthetic group (0.125% ropivacaine,group R)and a combination of local anesthetic and opioidergic analgesic group (0.125% ropivacaine+0.3 μg/ml sufentanil,group RS). Analgesic efficacy was measured using numerical rating scale (NRS)of pain and maternal visual ana-logue scale (VAS)analgesia satisfaction with regard to the first and the second stage of labor.Anal-gesic safety was measured with the Bromage scale of maternal safety and epidural labor analgesia re-lated side effects,as well as fetal safety including Apgar scoring and umbilical cord artery blood gas a-nalysis.Results A total of 346 participants completed the study,with 1 64 and 182 women in each group R and RS,respectively.The median NRS pain score during the first stage of labor was signifi-cantly lower in the combination group (2.2,IQR:1.8-2.7 )comparing to the sole local analgesic group (2.4,IQR:2-2.8)(P <0.001).No significant difference was observed in NRS pain score dur-ing the second stage of labor.Patients in both groups were rated the same VAS satisfaction of analge-sia.Patients in the sole local analgesic group experienced fewer side effects than those in the combina-tion group (37.7% versus 47.2%,P =0.082).The incidence of 1-min Apgar≤7 was lower in the sole local analgesic group 2 (1.2%) than the combination group 10 (5.5%) (P < 0.05 ). Conclusion The sole local anesthetic ropivacaine produces a comparable labor analgesic effect as the combination of both local anesthetic ropivacaine and opioidergic analgesic sufentanil but the former has less maternal side effects,and less incidence of lower 1-min Apgar scoring.
