低浓度罗哌卡因阴道分娩镇痛对产妇产期发热及致热因子的影响

Effect of vaginal delivery analgesia with low-concentration ropivacaine on maternal fever factors and pyretic cytokines

  • 摘要: 目的 探讨低浓度罗哌卡因阴道分娩镇痛对产妇产期发热及致热因子的影响。 方法 选取本院收治的120例初产妇作为观察对象,根据随机数字表法将其分为3组, Ⅰ、Ⅱ、Ⅲ组分别采用0.075%、0.100%、0.125%罗哌卡因阵痛。对3组产妇鼓膜温度、产程时间及镇痛时间、血清致热因子、产妇发热率及新生儿体质量和Apgar评分进行比较。 结果 3组产妇镇痛3 h后、胎儿娩出即刻、分娩后2 h的鼓膜温度情况与镇痛前比较差异无统计学意义(P>0.05); 镇痛4、5 h的鼓膜温度情况与镇痛前比较,差异有统计学意义(P<0.05); 3组产妇第一产程及第三产程组时间比较差异无统计学意义(P>0.05); 第二产程时间、镇痛时间比较, Ⅰ组短于Ⅱ组, Ⅱ组短于Ⅲ组(P<0.05); Ⅲ组发热率高于Ⅰ组及Ⅱ组,差异有统计学意义(P<0.05); 镇痛前、胎儿娩出即刻及分娩2 h后, 3组产妇的血清致热因子水平比较差异无统计学意义(P>0.05); 与镇痛前比较,胎儿娩出即刻及分娩2 h后3组产妇的白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)水平均有所升高,且胎儿娩出即刻时血清致热因子水平升高更为显著(P<0.05); 3组新生儿体质量及1 min、5 min Apgar评分比较差异无统计学意义(P>0.05)。 结论 低浓度罗哌卡因分娩镇痛产妇发热率低,产妇分娩期间发热与致热因子水平升高相关,但不同浓度罗哌卡因对致热因子水平影响差异不大。

     

    Abstract: Objective To investigate effect of vaginal delivery analgesia with low-concentration ropivacaine on maternal fever and pyretic cytokine. Methods A total of 120 primiparas admitted to our hospital were selected as research objects and divided into three groups according to random number table method. Groups Ⅰ, Ⅱ and Ⅲ were given ropivacaine at concentrations of 0.075%, 0.100% and 0.125%ropivacaine, respectively, for delivery analgesia. The tympanic membrane temperature, duration of labor and analgesia, serum pyretic cytokine, maternal fever rate, neonatal body index and Apgar score were compared among the three groups. Results There were no significant differences in tympanic membrane temperature after 3 hours of analgesia, immediately after delivery and at 2 hours after delivery compared to analgesia before between the three groups(P>0.05). The tympanic membrane temperature at 4 and 5 hours after analgesia showed significant differences than analgesia before(P<0.05). There was no significant difference in time of the first and third stages of labor in the three groups(P>0.05); the time of the second stage labor and time of analgesia in group Ⅰ were shorter than that in group Ⅱ, and group Ⅱwas shorter than group Ⅲ in above indicators(P<0.05); the fever rate in group Ⅲ was higher than that in group Ⅰ and group Ⅱ, and the - difference were statistically significant(P<0.05). There was no significant difference in the levels of serum febrile factors among the three groups before analgesia, immediately after delivery and 2 hours after delivery(P>0.05). Compared with before analgesia, the levels of interleukin-6(IL-6), interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in the three groups immediately after delivery and 2 hours after delivery were all increased, and the level of serum pyrogenic factor increased significantly immediately after delivery(P<0.05). There were no significant differences in neonatal body mass and Apgar scores at 1 and 5 min between the three groups(P>0.05). Conclusion The fever rate of ropivacaine analgesia at a low concentration for parturients is low, but there is no significant effects of different concentrations of ropivacaine on the level of pyretic cytokines.

     

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