雷米芬太尼静脉全程分娩镇痛联合导乐陪伴对母婴的影响

Effects of PCIA with remifentanil combined with doula for labor analgesia on maternity and neonate

目的探讨雷米芬太尼静脉分娩镇痛联合导乐陪伴(由助产士全程分娩陪伴)对母婴的影响。方法60例足月妊娠初产妇进入第一产程潜伏期后实施分娩镇痛联合导乐陪伴(A组)、分娩镇痛(B组)和导乐陪伴(C组),每组20例。记录产妇生命指征、镇痛镇静效果、分娩过程、不良反应及新生儿评分。结果A和B组镇痛优于C组(P<0.01),A、C组产程短于B组(P<0.05),A组产妇满意度最高。组间新生儿评估指标无显著差异。三组均无严重不良反应发生。结论雷米芬太尼静脉全程分娩镇痛联合导乐陪伴镇痛效果确切、产程缩短,对母婴无不良影响。

Objective To study the effects of patient-controlled intravenous analgesia（PCIA） with remifentanil combined with doula（parturient is accompanied by a midwife in the whole labor course） for labor analgesia on maternity and neonate.Methods Sixty full-term pregnancy nulliparous parturients were randomly divided into three groups with 20 cases each.PCIA with remifentanil combined with doula was used in group A,PCIA with remifentanil alone in group B and doula alone in group C.The vital signs,analgesia and sedation scores,labor course and side effects,and neonatal scores were recorded.Results VAS points in groups A and B during analgesia were lower than those in group C（P0.01）.Duration of the first and second labor stages in groups of A and C were shorter than that in group B （P0.05）.The maternal satisfaction score of group A was the highest （P0.05）.There were no significant differences among three groups in neonatal scores.All groups had no serious side effects or complications.Conclusion PCIA with remifentanil combined with doula for labor analgesia can provide effective analgesia and shorten the labor course with no serious side effects or complications in maternal and neonatal.