Clinical Study Of Continuous Epidural Anesthesia Of Nalbuphine Combined With Ropivacaine On Labor Analgesia

Objective To study the analgesic effect of continuous epidural anesthesia with nalbuphine combined with ropivacaine and its effect on maternal and infant safety,and to compare it with the traditional sufentanil combined with ropivacaine for continuous epidural anesthesia,in order to provide reference for the optimization of labor analgesic drug regimen.Methods Using a randomized double-blind control method,180 single-term primiparous who voluntarily chose labor analgesia（age 20-35 years old,BMI 20-35 kg/m2,ASA≤grade II）were randomly divided into NR group（0.3 mg/ml nalbuphine and 0.1%ropivacaine）and SR group（0.3μg/ml sufentanil and 0.1%ropivacaine）,90 cases in each group.Both groups of parturients with cervical dilation of 2 cm underwent labor analgesia and the above-mentioned liquids were used for patient-controlled epidural analgesia（PCEA）.Record the time of onset of analgesia,the time of the first PCA,the total amount of PCA drugs,PCA compressions,effective compressions and ropivacaine consumption per unit time.VAS score,general vital signs,Ramsay Sedation score and modified Bromage score were recorded before analgesia（T₀）,30 min（T₁）,60 min（T₂）after beginning of analgesia,the uterine cervix fully dilated（T₃）,during labor（T₄）and 2 h after delivery（T₅）,respectively.Newborn’s Apgar score,umbilical artery blood gas indicators and neurological adaptability score（NBNA）were recorded.The time of the first and second stage of labor,the time of first lactation,hemorrhage volume and the incidence of side effect were recorded.Results Compared with group SR,the onset time of analgesia of the parturients in group NR was faster（P<0.05）,but the first PCA time was shorter（P<0.05）.Total amount of PCA drugs,compressions,effective compressions and the consumption of ropivacaine were significantly increased（P<0.05）.Compared with the group SR,the parturients in group NR had significantly higher VAS scores at T₃（P<0.05）.There was no statistically significant difference in VAS scores between the two groups at T₀-T₂and T₄-T₅（P>0.05）.There were no significant differences in general vital signs,Ramsay sedation score,modified Bromage score,the first lactation time,the amount of bleeding,incidence of side effect between the two groups（P>0.05）.There was no statistical significance in the indexes of umbilical artery blood gas and NBNA score between the two groups of neonate（P>0.05）.Conclusions Compared with sufentanil for epidural labor analgesia,nalbuphine has a faster onset time,but it has a higher VAS score and a higher consumption of ropivacaine when uterine cervix fully dilated.Both can significantly reduce labor pain and have no effect on neonatal umbilical artery blood gas and NBNA score.