Journal of Developmental Medicine(Electronic Version)  2024, Vol. 12 Issue (6): 432-437,456 DOI: 10.3969/j.issn.2095-5340.2024.06.004 |
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| Application effect of different doses of nalbuphine combined with sufentanil in epidural labor analgesia and its influence on parturients and infants |
| Liu Guodong, Jia Yugang, Qiang Ruihua, et al
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(Department of Anesthesiology, Tangshan Maternal and Child Health Hospital, Hebei, Tangshan 063000, China)
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Abstract 【Abstract】 Objective To investigate the effect of different doses of nalbuphine combined with sufentanil in epidural labor analgesia and its effect on parturients and infants. Method Prospective selection of 160 single primiparou women who chosed vaginal delivery and voluntarily accepted epidural analgesia inTangshan Maternal and Child Health Hospital from January 2022 to January 2024 were conducted, aged 23-35 years, with a body mass index (BMI) of 25-35 kg/m2, and American Society of Anesthesiologists(ASA) grade ⅠorⅡ. They were divided into 4 groups by random number table method, including groupC ( sufentanil 0.4 μg/L + 0.1% ropivacaine), group N1 (nalbuphine 0.05 g/L + sufentanil 0.4 μg/L + 0.1%ropivacaine), group N2 (nalbuphine 0.1g/L + sufentanil 0.4 μg/L + 0.1% ropivacaine), and group N3 (nalbuphine0.15 g/L + sufentanil 0.4 μg/L + 0.1% ropivacaine), with 40 cases in each group. All patients in four groupswere given patient-controlled epidural analgesia (PCEA). The general vital signs, visual analogue scale (VAS)of pain, Ramsay sedation score of the patients were observed before labor analgesia (T0), 30 min after laboranalgesia started (T1), 60 min after labor analgesia started (T2), at the time of cervix opening (T3), at the timeof delivery start (T4), and 2 h after delivery (T5). The onset time of analgesia, duration of analgesia, numberof PCEA button presses, incidence of adverse reactions in the parturients and the infants, and the Apgarscore and neonatal behavioral neurological assessment (NBNA) score of the infants and maternal Montrealcognitive assessment (MoCA) score and symbol digit modalities test 90 (SDMT 90) score were recorded.Statistical methods performed by t-test, repeated measures ANOVA, and χ2 test. Result Compared withT0, VAS score of pain was significantly decreased and Ramsay sedation score was increased at each timeafter analgesia in four groups, the differences were statistically significant (P<0.05). Compared with groupC, VAS score of pain, onset time of analgesia, the number of patient-controlled analgesic pump compressionswere decreased, Ramsay sedation score and duration of analgesia were increased in three groups. The incidenceof nausea, vomiting and pruritus in group N2 and group N3 were significantly decreased, the differences were statistically significant (P<0.05). Compared with group N1, VAS score of pain, onset time of analgesia, the number
of patient-controlled analgesic pump compressions, the incidence of complications were decreased, duration ofanalgesia in group N2 and group N3 were increased, Ramsay sedation score and incidence of drowsiness ingroup N3 were increased, the differences were statistically significant (P<0.05). Compared with group N2,Ramsay sedation score and incidence of drowsiness in group N3 were increased after the onset of analgesia,the differences were statistically significant (P<0.05). There were no significant differences in 1 min and 5 minApgar score after birth, the incidence of fetal distress and wet lung among the four groups (P>0.05). There wereno significant differences in NBNA score of infants, MoCA scale score and SDMT90 score of parturients amongthe four groups (P>0.05). Conclusion The analgesic effect of 0.1 g/L nalbuphine combined with 0.4 μg/Lsufentanil and 0.1% ropivacaine for epidural labor analgesia is satisfactory, the incidence of adverse reactions islow, and has no effect on the neurological function of infants and parturients. It can be safely and effective lyapplied to labor analgesia in parturients.
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Received: 17 April 2024
Published: 27 November 2024
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