腰硬联合麻醉用于分娩镇痛的临床观察

Clinical observation on effect of CSEA in labor painkilling.

目的:探讨腰麻-硬膜外联合阻滞用于分娩镇痛的效果及对产程、母婴的影响。方法:将80例产妇随机分为观察组和对照组两组,观察组(40例)在蛛网膜下腔隙注入芬太尼15μg,PCEA用0.1%罗哌卡因+芬太尼2μg/m l,6 m l/h。对照组(40例)不行镇痛。观察两组镇痛效果、运动神经阻滞、产程时间、分娩方式、新生儿Apgar评分情况。结果:观察组镇痛效果明显优于对照组(Hc=35.79,P<0.01),无运动神经阻滞,活跃期明显缩短(t=5.21,P<0.01),两组剖宫产率和新生儿Apgar评分比较差异无统计学意义(P>0.5)。结论:腰硬联合麻醉用于分娩镇痛效果确切,不影响产程及新生儿。

Objective： To explore the effect of combined spinal-epidural anesthesia （CSEA） in labor painkilling and its influence on labor course and mother and infants. Methods：80 cases premature intant were divided into 2 groups randomly, observation group （40 cases） was injected with fentanyl 15 μg, after turning and lie horizontally, given 0.1% ropivacaine and 2 μg/ml fentanyl epidurally and conduct PCEA, infusion speed 6 ml/h; comparison group （40 cass） did not adopt the treatment of labor painkilling. The effect of painkilling and blocking, the duration of total labor course, the mode of delivery and neonatal Apgar scores were observed. Results： Observation group was better in labor painkilling than comparison group obviously （Hc=35.79, P〈0.01） and no blocking. The active time was shorter obviously（t=5.21,P〈0.01） .There was no significant difference in the two groups in the rates of cesarean section and neonatal Apgar scores （P〉0.05）. Conclusion： CSEA is sure, effect in labor painkilling and has no influence on delivery course and neonates.