Clinical study of combined spinal and epidural block with hydromorphone and ropivacaine for labor analgesia in women with pregnancy-induced hypertension
Objective To explore the value of combined spinal and epidural block with hydromorphone and ropivacaine for labor analgesia in women with pregnancy-induced hypertension.Methods 90 primiparous women with singleton pregnancy and pregnancy-induced hypertension were selected as study subjects and randomly divided into group H1(hydromorphone 10 μg/ml+0.1%ropivacaine),group H2(hydromorphone 15 μg/ml+0.1%ropivacaine),and group F(fentanyl 2 μg/ml+0.1%ropivacaine),with 30 cases in each group.All three groups received 0.1%ropivacaine 3 mg for lumbar anesthesia.Comparison was made on visual analogue scale(VAS)score and mean arterial pressure(MAP)before analgesia(T0),5 min after analgesia(T1),30 min after analgesia(T2),1 h after analgesia(T3),2 h after analgesia(T4),complete dilation of the cervix(T5)and fetal delivery(T6),total duration of labor,mode of delivery,neonatal Apgar score,motor block,occurrence of adverse reactions,intrapartum fever and satisfaction among the three groups.Results The VAS scores of the three groups had no significant difference at T0(P>0.05),and decreased at T1-T6 compared with T0(P<0.05).The VAS scores in group H1 and group H2 were significantly lower than those in group F at T3-T6(P<0.05),but there was no significant difference in VAS scores between group H1 and group H2 at T3-T6(P>0.05).Compared with T0,MAP of the three groups was decreased at T1-T6(P<0.05).There were no significant differences in the total duration of labor,mode of delivery and Apgar score at 1 min and 5 min after birth among the three groups(P>0.05).There was no significant difference in the percentage of modified Bromage grade 0 and intrapartum fever among the three groups(P>0.05).The incidence rate of maternal adverse reactions in group H1 was 10.0%,which was lower than that in group H2(33.3%)and group F(36.7%);and the overall satisfaction rate was 93.3%,which was higher than that in group H2(66.7%)and group F(66.7%)(P<0.05).Conclusion 10 μg/ml hydromorphone+0.1%ropivacaine patient-controlled epidural analgesia combined with 0.1%ropivacaine 3 mg subarachnoid block analgesia has a fast onset of action,good analgesic effect,and fewer adverse reactions,and can be safely used for labor analgesia in women with pregnancy-induced hypertension.
HydromorphoneRopivacaineCombined spinal and epidural blockPregnancy-induced hypertensionPostpartum womenLabor analgesia
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