Effect of epidural labor analgesia with oxymorphone and ropivacaine on pain stress and labor stage in primiparas
10.13699/j.cnki.1001-6821.2023.24.011
- VernacularTitle:氢吗啡酮与罗哌卡因硬膜外分娩镇痛对初产妇疼痛应激及产程的影响
- Author:
Tian-Yu SUN
1
;
Hui-Dong GAO
;
Jia-Hui CHANG
;
Xiao-Wei YU
;
Jian-Jun XU
Author Information
1. 大庆油田总医院麻醉手术科,黑龙江大庆 163000
- Keywords:
oxymorphone;
ropivacaine;
labor analgesia;
pain stress;
labor stage;
temperature receptor
- From:
The Chinese Journal of Clinical Pharmacology
2023;39(24):3593-3597
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effects of epidural labor analgesia with oxymorphone and ropivacaine on pain stress,labor stage and temperature receptor in primiparas.Methods According to different analgesia methods,primiparas under went labor analgesia were divided into oxymorphone group and ropivacaine group.The oxymorphone group was given 40 μg·mL-1 oxymorphone hydrochloride for patient-controlled epidural analgesia(PCEA),while ropivacaine group was given 0.1％of ropivacaine for PCEA.The pain stress,labor stage,intrapartum fever,effective pressure times and total times of analgesic pump,and neonatal Apgar score in the two groups were recorded.The adverse reactions in the two groups were observed.Results There were 42 cases in oxymorphone group and 48 cases in ropivacaine group.After analgesia,scores of visual analogue scale(VAS)in oxymorphone group and ropivacaine group immediately after uterine complete opening(T3)were(2.68±0.37)and(3.08±0.52)points,VAS scores after fetal delivery(T4)were(3.12±0.31)and(4.15±0.26)points,VAS scores at 1 h after placenta delivery(T5)were(1.36±0.13)and(1.45±0.12)points,and the differences were statistically significant.In oxymorphone and ropivacaine groups at 30 min after analgesia,levels of serum cortisol(Cor)were(276.69±25.74)and(289.64±24.52)nmol·L-1,and levels of serum norepinephrine(NE)were(2.21±0.17)and(2.39±0.11)pg·mL-1,respectively.AtT4,levels of serum Cor in oxymorphone and ropivacaine groups were(146.36±18.97)and(202.83±22.68)nmol·L-1,levels of serum NE were(1.71±0.19)and(1.95±0.16)pg·mL-1,the differences were all statistically significant(all P＜0.05).The total labor stage in oxymorphone group and ropivacaine group were(573.26±162.37)and(566.38±171.45)min,the difference was not statistically significant(P＞0.05).The incidence of intrapartum fever in oxymorphone group and ropivacaine group were 4.76％and 18.75％,the differences were statistically significant(P＜0.05).The effective pressure times of analgesic pump in oxymorphone group and ropivacaine group were(6.18±1.12)and(7.19±1.23)times,total pressure times were(6.52±1.69)and(7.81±1.74)times,the differences were all statistically significant(all P＜0.05).The neonatal 1 min Apgar scores in oxymorphone group and ropivacaine group were(9.21±0.26)and(9.19±0.24)points,5 min Apgar scores were(9.56±0.12)and(9.53±0.19)points,the difference was not statistically significant(P＞0.05).The incidence rates of nausea in hydromorphone group and ropivacaine group were 23.81％and 6.25％,vomiting were 21.43％and 4.17％,dizziness were 17.39％and 4.17％,the differences were statistically significant(all P＜0.05).Conclusion Compared with ropivacaine,oxymorphone has better analgesic effect in primiparas,which can effectively reduce pain stress,has fewer effects on temperature receptors and will not affect labor stage and neonatal outcomes.But oxymorphone has higher incidence of adverse drug reactions than ropivacaine.
