Effects On Puerpera And Fetal Blood Flow Indices When Combine Ropivacaine With Sufentanil In Epidural Analgesia

BackgroundIn our country,epidural labor analgesia is now the most commonly used method to reduce labor pain.Ropivacaine combine with sufentanil is the most commonly used drugs,but the effects on maternal and fetal blood flow is still not very clear,and fetal health is closely related to the blood supply of maternal and fetal.To evaluate the effect caused by epidural labor analgesia,we often need to combine the medical history,Apgar score,umbilical artery blood gas analysis with physical examination and neurological examination,but those indices have their shortcomings and limitations.So,we introduced in Doppler ultrasound technique.This study aims to learn the blood indices changes of uterine artery,fetal umbilical artery and middle cerebral artery by the help of Doppler ultrasound technique,so we can monitor fetal,find out unusual matters early,and provide the theoretical basis for its safety evaluation in clinical application.ObjectiveTo learn the blood indices changes of uterine artery,fetal umbilical artery and middle cerebral artery by the help of Doppler ultrasound technique in labor analgesia with ropivacaine and sufentanil.MethodsSelect 50 first-time mothers as group RS who volunteered for labor analgesia in our hospital from January 2016 to December,and 50 patients were selected as group C who had refused glabor analgesia.Group RS was treated with epidural analgesia?0.125%ropivacaine+0.4?g/ml sufentanil,PCEA?when the maternal cervix was raised to 3.0 cm.Group C was no analgesic.Mater labor time,blood loss,neonatal Apgar score and fetal umbilical artery blood gas analysis results of two groups were recorded.We also recorded blood indices of maternal uterine artery,umbilical artery and fetal middle cerebral artery on these time points:time before analgesia?T₀?,20 min after analgesia?T₁?,40 min after analgesia?T₂?,60 min after analgesia?T₃?,120 min after analgesia?T₄?and the time maternal cervix open to full?T₅?,we recorded these arteries'resistance index?RI?,pulse index?PI?and the maximum peak blood flow velocity/end-diastolic blood flow velocity?S/D?in group RS.Group C was recorded the same indices by the same time.We also recorded the adverse reactions.ResultsBoth groups had successful delivery.There was no statistically significant difference between the first labor time,the second labor time,the amount of blood loss and the pH,PO2 and PCO2.1-minute-Apgar-score and 5-minute-Apgar-score of the two groups of newborns were all more than 8,and there was no statistically significant difference between them.At time T1,the RI,PI and S/D indices of the maternal uterine artery in the RS group were lower than that in group C,and there was no significant change in uterine artery flow in the two groups at other time points.At each time point,the blood flow indices change of fetal umbilical artery and fetal cerebral artery was not obvious in both groups.One case in group RS had the skin inch which got better after treatment,group RS and group C had no adverse reactions such as low blood pressure,nausea,vomit and anesthetics poisoning.ConclusionRopivacaine compound sufentanil is used for epidural labor analgesia which obviously reduces maternal pain and ensures the comfort of delivery.1.It has no significant effect on fetal umbilical artery and fetal middle cerebral artery blood flow indices.2.It does not extend maternal labor time.