双管硬膜外麻醉联合用药在无痛分娩中的应用

Application of epidural anesthesia by catheterized double narcosis-tubes with low concentration of bupivacaine or ropivacaine and fentany on painless labor

目的:比较低浓度布比卡因与罗哌卡因配伍芬太尼用于双管硬膜外麻醉无痛分娩的效果。方法:选择无明显头盆不称的足月单胎头位产妇60例(镇痛组),分为A组(30例)与B组(30例),分别实施低浓度布比卡因与罗哌卡因配伍芬太尼双管硬膜外分娩镇痛,观察镇痛效果及不良反应,并与同期未加干预的60例产妇(对照组)比较产程时间、分娩方式、新生儿评分及产后出血量。结果:A组与B组的镇痛有效率分别为96.7%(29/30)、100.0%(30/30),均无明显并发症出现。镇痛组的产程时间、分娩方式、新生儿评分及产后出血量与对照组比较差异均无统计学意义(P>0.05)。结论:低浓度布比卡因与罗哌卡因配伍芬太尼用于双管硬膜外麻醉无痛分娩镇痛效果确切,满意度高,对母婴无不良反应,有良好的临床应用前景。

Objective： To investigate the clinical effect of epidural anesthesia by catheterized double narcosistubes with low concentration of bupivacaine or ropivacaine and fentany on painless labor. Methods： A comparative analysis was carried out between 30 pregnant woman given by peridural anesthes with low concentration of bupivacaine and fentany and 30 with ropivacaine and fentany during labor（study group） respectively and 60 pregnant woman （control group） not accepting any painless labor in the same time. The painless effect, side effect, labor course, labor way, Apgar scores and postpartum hemorrhage amount were observed in both groups. Result.. There were 96.7% and 100% painless effective rates and less side effect in the bupivacaine group and the ropivacaine group respectively. There were no significant differences in the labor course, labor way, Apgar scores and postpartum hemorrhage amount between the study groups and the control group （P〉0.05）. Conclusions： The painless labor under epidural anesthesia by catheterized double narcosis-tubes with low concentration of bupivacaine or rupivacaine and fentany have same better painless effect and no side effect on the mothers and infants. Both are safe, effective and worthy of being popularized widely.