罗哌卡因复合芬太尼硬膜外自控镇痛用于分娩镇痛临床疗效

PERIDURAL AUTO CONTROL ANALGESIA WITH RAPIVACAINE AND FENTANYL TO TREAT DELIVERY PAIN

目的观察罗哌卡因复合芬太尼硬膜外自控镇痛(PCEA)在分娩镇痛中的临床效果。方法收集我院ASA1～2级自愿要求镇痛、无禁忌症的初产妇120例为观察组,采用罗哌卡因复合芬太尼硬膜外阻滞麻醉,连接微量泵硬膜外自控镇痛;以同期未采取任何干预性镇痛措施进入产程的120例初产妇为对照组,观察两组产妇的疼痛程度、产程、分娩方式、产后出血、胎儿窘迫、新生儿Apgar评分情况。结果观察组疼痛程度较对照组明显减轻,第一产程活跃期较对照组明显缩短,剖宫产率较对照组明显下降(P<0.01),两组第二产程、产钳助产率、产后出血量、胎儿宫窘迫、新生儿窒息发生率比较差异无显著差异(P>0.05)。结论罗哌卡因复合芬太尼硬膜外自控镇痛用于分娩镇痛效果显著,缩短第一产程活跃期,降低剖宫产率,对母婴无影响,是目前最理想的镇痛方法。

Objective To explore the clinical effects of peridural auto-control analgesia（PACA） with rapivacaine and fentanyl on delivery pain. Methods 120 primiparae without contraindications in the treatment group volunteered to receive delivery analgesia through PACA by means of block anesthesia and micro-pump. Another 120 cases received no interrentions in delivery. Observations were made to evaluate the pain, the birth process, the delivery method, the postpartum bleeding and the fetal distress in both groups according to the Apgar Scales. Results In the first stage of labor, the treatment group got less pain, shorter active period and less casarean sections than the contrast group（ P 〈0.01）. In the second stage of labor,no significant differences were found between the two groups in terms of the rates of using forceps delivery, the amount of bleeding, fetal distress and the rate of asphyxia neonatorum （ P 〉 0.05）. Conclusion The PACA with rapivacaine and fentanyl can produce good delivery analgesia,shorten the active period in the first stage of labor and reduce the rate of cesarean sections without causing bad effects on both parturients and their babies.