Effect of low dose ropivacaine combined with low dose fentanyl on labor analgesia in patients with pregnancy induced hypertension / 中国基层医药

ABSTRACT

Objective To investigate the effect of low dose ropivacaine combined with low dose fentanyl on labor analgesia in patients with pregnancy induced hypertension.Methods From January 2012 to June 2016, 120 cases of pregnant women with hypertension in Lishui Central Hospital were selected ,and they were divided into observation group and control group according to the random number method,with 60 case in each group.The observation group was treated with epidural anesthesia ,the control group was not anesthetized.The systolic blood pressure(SBP), diastolic blood pressure ( DBP), VAS score, delivery mode, oxytocin application, labor, neonatal Apgar score, postpartum hemorrhage during the delivery of the two groups were collected.Results The SBP and DBP at 10min after anesthesia,active period,the second stage of labor in the observation group were (135.76 ±11.64) mmHg, (136.57 ±7.68) mmHg,(141.23 ±9.78) mmHg,(84.56 ±6.57) mmHg,(85.46 ±7.21) mmHg,(85.47 ± 7.27)mmHg,respectively,which were lower than those in the control group [(156.35 ±14.37) mmHg,(158.71 ± 8.2)mmHg,(172.15 ±14.65)mmHg,(107.58 ±7.68)mmHg,(108.68 ±9.04)mmHg,(113.24 ±11.53)mmHg] (t＝8.674,8.253,9.934;15.476,14.278,17.054,all P＝0.000).The VAS scores at 10min,40min,80min, 120min after anesthesia in the observation group were (6.23 ±1.12 ) points, ( 1.67 ±0.82) points, ( 1.16 ± 0.64)points,(1.63 ±0.75) points,respectively,which were significantly lower than those in the control group [(7.18 ±1.08)points,(7.37 ±0.99)points,(7.68 ±0.94)points,(7.58 ±0.87)points] (t＝4.758,33.264, 41.867,35.286,all P＝0.000).The rate of cesarean section in the observation group (28.3%) was lower than that in the control group (56.7%) (χ2＝9.855,P＝0.002).The rate of vaginal delivery and oxytocin application in the observation group(46.7%,55.0%) were higher than those in the control group (21.7%,28.3%) ( χ2＝8.336, 8.777,P＝0.004,0.003).There were no statistically significant differences in the first stage of labor ,the second stage of labor,the third stage of labor,the 1 min Apgar score,5 min Apgar score and the postpartum hemorrhage between the two groups(P＝0.410,0.376,0.207,0.289,0.243,0.486).Conclusion The low dose ropivacaine combined with small dose of fentanyl for the labor analgesia of pregnant women with hypertensive disorder can reduce blood pressure,reduce childbirth pain ,reduce cesarean section rate ,improve vaginal delivery rate during delivery.