Effect of sufentanil combined with low concentration of ropivacaine anaesthetizing in spinal epidural for labor analgesia on pregnancy outcome

Abstract

Objective To investigate the effect of sufentanil combined with low concentration of ropivacaine anaesthetizing in spinal epidural for labor analgesia on pregnancy outcome. Methods Using the prospective design method, we selected 200 cases of primipara from December 2014 to December 2015 for the study. 200 cases of primipara were randomly divided into observation group (100 cases) and control group (100 cases). The observation group received sufentanil combined with low concentration of ropivacaine combined spinal and epidural anesthesia. The stage of labor, VAS, postpartum hemorrhage, delivery status, the incidence of adverse reactions, the levels of cortisol and nitric oxide (NO) in the two groups were compared. Results In the observation group, the first stage of labor was (364.7±187.6)min, the second stage of labor was (53.6±10.7)min, the third stage of labor was (10.15±4.83)min; the VAS score at T1 time point, T2 time point were (6.23±1.19) and (1.25±0.39); the postpartum hemorrhage was (264.8±74.6) ml. In the control group, the first stage of labor was (323.2±104.7)min, the second stage of labor was (55.9±8.5)min, the third stage of labor was (10.27±5.04)min; the VAS score at T1 time point, T2 time point were (6.04±1.36) and (7.84±1.63); the postpartum hemorrhage was (281.9±80.5) ml. The VAS score of the observation group was significantly lower than that of the control group, with statistically significant difference (P 0.05). The natural delivery rate of the observation group was 79%, the vaginal midwifery rate was 7%, the cesarean section rate was 14%; those of the control group were 50%, 10%, and 40%; the natural delivery rate of the observation group was higher than that of the control group, the cesarean section rate was lower than that of the control group, with statistically significant differences (P 0.05). The incidences of neonatal jaundice, low-birth weight infant, and macrosomia of the observation group were 3%, 1%, and 1%, those of the control group were 5%, 3%, and 2%, there were no statistically significant differences between the two groups (P>0.05). The incidence of skin itch of the observation group was 14%, the incidences of hypotension and respiratory depression were 0%, the incidence of nausea and vomiting was 7%, the incidence of lower limb numbness was 3%, the incidence of urinary retention was 4%; the incidences of skin itch, hypotension, respiratory depression, and lower limb numbness of the control group were 0%, the incidence of nausea and vomiting was 1%, the incidence of urinary retention was 6%; the incidences of skin itch, nausea and vomiting of the observation group were higher than those of the control group (P<0.05), which all disappeared after the end of delivery. The levels of cortisol at T1 time point, T2 time point, T3 time point of the observation group were (817±146), (742±105), (703±124) ng/ml, those of the control group were (825±103), (859±117), (914±138) ng/ml; the levels of NO at T1 time point, T2 time point, T3 time point of the observation group were (92.6±17.5), (93.5±18.7), (96.4±10.3)μmol/L, those of the control group were (91.7±13.2), (82.7±17.2), (80.6±12.7)μmol/L; the level of cortisol of the observation group significantly decreased, the level of cortisol of the control group significantly increased, the level of NO of the control group significantly decreased (P<0.05). Conclusions Sufentanil combined with low concentration of ropivacaine anaesthetizing in spinal epidural can significantly reduce maternal childbirth pain, raise the natural delivery rate and reduce the rate of cesarean section with no security risks of maternal and newborn, which has good application value in clinical practice. Key words: Sufentanil; Ropivacaine; Spinal epidural anesthesia; Labor analgesia; Pregnancy outcome