Application effect of different concentrations of ropivacaine hydrochloride combined with sufentanil epidural anesthesia in analgesic delivery and its impact on pain severity and postpartum complications
Objective To explore the application effect of different concentrations of ropivacaine hy-drochloride combined with sufentanil epidural anesthesia in analgesic delivery and its impact on pain severity and postpartum complications.Methods The study was a prospective study.A total of 120 women with vaginal deliv-ery admitted to Hongdong County People's Hospital from March 2021 to March 2024 were selected and divided into 4 groups:A,B,C,and D,with 30 cases in each group.All parturients were treated with ropivacaine hy-drochloride combined with sufentanil epidural anesthesia.The concentration of ropivacaine hydrochloride in Group A was 0.15％,Group B was 0.1％,Group C was 0.075％,and Group D was 0.05％.The concentration of sufentanil in all four groups of parturients was 0.5 μg/ml.The changes in diastolic blood pressure,systolic blood pressure,heart rate levels,pain severity,labor duration,stress hormone changes,and incidence of complications were com-pared among four groups of parturients.Results After 5 minutes of analgesia,10 minutes after analgesia,and immediately after full opening of the cervix,the diastolic blood pressure[(79±4) mmHg,(75±8) mmHg,(80±5) mmHg],systolic blood pressure[(116±10) mmHg,(114±6) mmHg,(117±6) mmHg],and heart rate[(83±8) beats/min,(79±5) beats/min,(81±5) beats/min]in Group A,as well as the diastolic blood pressure[(81±7) mmHg,(76±6) mmHg,(81±6) mmHg],systolic blood pressure[(119±10) mmHg,(115±6) mmHg,(118±7) mmHg],and heart rate[(84±5) beats/min,(80±4) beats/min,(80±4) beats/min]in Group B,were all lower than those in Group C and Group D (P<0.05).However,there was no statistically significant difference between Group A and Group B ( P>0.05).The visual analog scale (VAS) scores[(5.80±0.42) points,(3.15±0.25) points,(4.21±0.35) points]and Group B[(5.88±0.24) points,(3.17±0.34) points,(4.38±0.28) points]were all lower than those of Group C and Group D (P<0.05) after 5 minutes of analgesia,10 minutes after analgesia,and immediately after full opening of the cervix.However,there was no difference between Group A and Group B (P>0.05).The first and second stages of labor in Group A[(627.7±86.2) min,(55.4±4.5) min]were higher than those in Group B,Group C and Group D,but there was no difference between Group B and Group C (P>0.05).Group A:Adrenaline (ADR)[(71±9) pg/ml,(62±4) pg/ml],norepinephrine (NE)[(452±39) pg/ml,(454±36) pg/ml],cortisol (COR)[(90±5) ng/ml,(92±8) ng/ml]during full opening of the cervix and fetal delivery;Group B:ADR[(73±6) pg/ml]during full opening of the cervix and fetal delivery L,(64±6) pg/ml],NE[(456±38) pg/ml,(456±32) pg/ml],COR[(90±8) ng/ml,(92±10) ng/ml]were all lower than those of Group C and Group D (P<0.05),but there was no difference between Group A and Group B (P>0.05).The incidence of complications in Group A was 40.00％ higher than that in Group B (13.3％),Group C (13.3％),and Group D (6.7％) (P<0.05),but there was no difference among the three groups B,C,and D.Conclu-sion There are significant differences in the application effect of different concentrations of ropivacaine hy-drochloride combined with sufentanil epidural anesthesia in analgesic delivery.Among them,ropivacaine hy-drochloride concentrations of 0.15％ and 0.1％ can improve intraoperative blood pressure and heart rate fluctua-tions,enhance analgesic effect,shorten labor process time,and reduce maternal stress reactions.However,0.15％ropivacaine hydrochloride may increase maternal complications.
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