Applicability of remifentanil in labor analgesia for parturients with HDP
LI Xiuman1,2, WANG Weimin2, ZHOU Xian3, LIU Yahua4
1. Hunan University of Medicine,Huaihua 418000,China; 2. Department of Anesthesiology,the First Affiliated Hospital of Hunan University of Medicine,Huaihua 418000,China; 3. Department of Anesthesiology,Huaihua City Maternal and Child Health Care Hospital,Huaihua 418000,China; 4. Emergence Dapartment, the Third Medical Centre, General Hospital of PLA,Beijing 100039,China
Abstract：Objective To evaluate the efficacy and safety of remifentanil used in labor analgesia among patients with hypertensive disorders of pregnancy (HDP). Methods A total of 80 pregnant women with HDP were selected and randomly divided into two groups (n=40): the observation group (intravenous remifentanil group) and the control group (epidural group). Mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR) and pulse oxygen saturation(SpO2) were recorded at different time points. VAS scores were measured at each time point, and the levels of satisfaction with labor analgesia were analyzed. The time of each stage of labor, maternal and neonatal adverse reactions were recorded. The Apgar score of newborns was determined and umbilical cord blood gas analysis was performed after delivery. Results There was no significant difference in MAP, HR or RR between the two groups at T0 (10 min before treatment). However, the MAP of the observation group was significantly higher than that of the control group 10 min (T1) and 60 min (T2) after treatment, and 10 min (T3) and 2 h (T4) after delivery (P<0.05). As for VAS scores, there was no significant difference between the two groups at T0 (P>0.05), but they were higher in the observation group than in the control group at each time point (T1-T2) after analgesia. There was no significant difference in patients’ level of satisfaction between the two groups (P>0.05). The incidence of hypotension and lower limb numbness in the observation group was lower than in the control group (P<0.05), but the incidence of dizziness was higher (P<0.05). There was no significant difference in blood gas indexes or in the incidence of asphyxia between the two groups (P>0.05). Conclusions Analgesia with remifentanil during labor is stable and ensures good compliance in patients with HDP.
李秀满, 王卫民, 周宪, 刘亚华. 瑞芬太尼静脉分娩镇痛在妊娠期高血压疾病中的应用[J]. 武警医学, 2021, 32(11): 933-936.
LI Xiuman, WANG Weimin, ZHOU Xian, LIU Yahua. Applicability of remifentanil in labor analgesia for parturients with HDP. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(11): 933-936.
Bawdane K D,Magar J S,Tendolkar B A. Double blind comparison of combination of 0.1% ropivacaine and fentanyl to combination of 0.1% bupivacaine and fentanyl for extradural analgesia in labour [J]. J Anaesthesiol Clin Pharmacol,2016,32(1):38-43.
Han B, Xu M. A comprehensive analysis of continuous epidural analgesia’s effect on labor and neonates in maternal hypertensive disorder patients[J]. Hypertens Pregnancy,2017,1(7):33-38.
[6]
Kumagai A, Makino S, Takeda J, et al.Characteristics of labor-onset hypertension persist after neuraxial labor analgesia[J]. J Obstet Gynaecol Res,2020,46(1):104-109.
[7]
Khedagi A M, Bello N A. Hypertensive disorders of pregnancy[J].Cardiol Clin,2021,39(1): 77-90.
[8]
Plummer M D, Andraweera P H, Garrett A, et al. Hypertensive disorders of pregnancy and later cardiovascular disease risk in mothers and children [J]. J Dev Orig Health Dis,2021,12(4):555-560.
[9]
Hastie R, Bergman L, Akhter T, et al. Duration of labor among women with hypertensive disorders of pregnancy; a Swedish register cohort study[J]. Eur J Obstet Gynecol Reprod Biol, 2020,251: 114-118.
[10]
Beninati M J, Ramos S Z, Danilack V A, et al.Prediction model for vaginal birth after induction of labor in women with hypertensive disorders of pregnancy[J]. Obstet Gynecol, 2020,136(2): 402-410.
Colvin Z, Feng M, Pan A, et al.Duration of labor induction in nulliparous women with hypertensive disorders of pregnancy and maternal and neonatal outcomes[J]. J Matern Fetal Neonatal Med,2020,12:1-8.
[16]
Deng C M, Ding, Li S, et al. Neuraxial labor analgesia is associated with a reduced risk of postpartum depression: A multicenter prospective cohort study with propensity score matching[J]. J Affect Disord,2021,15(281):342-350.
Felton M, Hundley V A, Grigsby S, et al. Effects of slow and deep breathing on reducing obstetric intervention in women with pregnancyinduced hypertension: a feasibility study protocol [J]. Hypertens Pregnancy,2021,40(1):81-87.
[19]
Sheibani L, Raymond K, Rugarn O, et al. Associations of hypertensive disorders of pregnancy and outcomes of labor induction with prostaglandin vaginal inserts[J]. Hypertens Pregnancy,2018,37(13):166-170.
Li L, Yang Z, Zhang W. Epidural dexmedetomidine for prevention of intrapartum fever during labor analgesia: a randomized controlled trial[J]. Pain Ther,2021,10(1):391-400.
2021, Vol. 32 
