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| Effect comparison of the different doses of ropivacaine combined with fentanyl for stepwise labor analgesia |
| Jiangning Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, 211101 |
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Abstract To investigate the effect comparison of the different doses of ropivacaine combined with fentanyl for stepwise labor analgesia. Methods: A total of 165 full-term pregnant women who wanted labor analgesia were selected and were divided into three groups by random number table method from January 2022 to June 2022. The women in the three groups were given epidural labor analgesia in the L3-L4 space, and the analgesic drug formulation was 100 ml of 0.1% ropivacaine hydrochloride combined with 2.0μg/ml fentanyl citrate, with the load was 8 ml, the single pressing dose was 6 ml, and the interval was 15 min. The women in group C were given the hourly pulsed bolus dosage of 6 ml during labor. The women in group A or in group B were given the hourly pulsed bolus dosage of 6 ml firstly, and then after the cervical opening to 5 cm, the infusion pulse volume was changed to 8 ml/h or 10 ml/h. Analgesic pump was stopped for the women in the three groups after their cervical opening to 10 cm. The VAS score, the modified Bromage score, and the uterine contraction situation of the women in the three groups were recorded when the cervix opening to 2 cm, 5 cm, and 10 cm, and at the time of delivery. The total labor time, the total dosage of analgesic drugs by pump infusion, the situation of oxytocin used, the delivery mode, the adverse reactions, the fetal heart changes, and the scores of neonatal Apgar of the women in the three groups were also recorded. Results：The VAS score of women at the cervix opening to 10 cm and at delivery in group C, group A, and group B had decreased gradually. The durations of the total labor and the first stage of labor of women in group C, group A, and group B had shortened gradually. The total dosage of analgesic drugs by pump infusion of women in group C, group A, and group B had decreased gradually (all P<0.05). There were no significant differences in the rate of oxytocin used, the Bromage score, the fetal heart rate change, the adverse reactions rate, the delivery outcomes, and the neonatal Apgar score of the women among the three groups (P>0.05). Conclusion: It is safe and effective to increase the infusion dosage of ropivacaine combined with fentanyl used for stepwise labor analgesia when the cervical opening to 5cm of the women, which can reduce the pain score by VAS, shorten the durations of the total labor and the first labor, and reduce the total dosage of analgesic drug by pump infusion of the women, and without increasing the adverse reactions. The analgesic effect was better when the infusion drug dosage was 10 ml/h.
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