Influence Of Ropivacaine With Sufentanil For Patient Controlled Epidural Analgesia On Maternal And Neonatal Outcomes

Objective:To evaluate the influence of ropivacaine with sufentanil for patient controlled epidural analgesia(PCEA)on the progress of labor,oxytocin use,mode of delivery,postpartum hemorrhage,maternal fever and neonatal.Methods:Nulliparous parturients of term,single fetal head position and been estimated to be vaginal delivery were selected from January 2016 to June 2016.These patients had no contraindication for epidural analgesia and ASA Ⅰ~Ⅱ grade.95 volunteers for PCEA were in analgesia group.171 cases without any pharmacotherapy were in control group.Parturients in PCEA group received 0.15% ropivacaine plus 0.5 μg.ml-1 sufentanil in active labor(cervical lilation=3cm),discontinuing in the endpoint of first labor stage.The control group was given routine obstetric treatment.The value of VAS,progress of labor,oxytocin use,mode of delivery,postpartum hemorrhage,maternal fever and newborn Apgar were compared between two groups.Results:There was no statistic differences on age,height,weight,gestational weeks,and neonatal birth weight between the two groups(P>0.05).The VAS of the PCEA group was significantly decreased(P<0.05).The time of first labor stage of PCEA group was M 480(P25258~P75675),comparing the control group M 300(P25220~P75480).The time of second labor stage of PCEA group was M 60(P2538~P75107),comparing the control group M 48(P2528 ~ P7560).Hence,the difference was statistically significant(P<0.05)in this aspect.There was no statistical difference between the third stage and postpartum hemorrhage(P>0.05).The usage rate of oxytocin was higher in PCEA group(P<0.05).The rate of cesarean section in the PCEA group was higher than that in the control group(P<0.05).There was no statistical difference on instrumental vaginal delivery and postpartum fever(P>0.05).Although the incidence of fetal heart rate was slightly higher in the PCEA group than in the control group(P<0.05),there was no statistical difference in neonatal Apgar score(P> 0.05).Conclusion:The regimen of 0.15% ropivacaine combined with sufentanil 0.5μg.ml-1 PCEA is effective.PCEA can prolong the labor process,increase oxytocin utilization rate and cesarean section rate.But it has no influence on the third stage of labor,postpartum hemorrhage,instrumental delivery,postpartum fever and neonatal Apgar score.