瑞芬太尼静脉自控式分娩镇痛的临床研究

Evaluation of patient-controlled intravenous analgesia with remifentanil for labor

探讨瑞芬太尼静脉自控或分娩镇痛的临床效果.瑞芬太尼0.1μg·kg＾-1·min＾-1静脉滴注用于分娩镇痛的健康初产妇302例为镇痛组,221例健康初产妇为对照组.两组用药前后视觉模拟评分法（VAS）评分差异有统计学意义（P＜0.01）;两组经阴道分娩产妇中,第1产程时间差异有统计学意义（P＜0.01）,第2产程时间、分娩方式、不良反应发生率等比较均无统计学意义（P＞0.05）.瑞芬太尼静脉用于自控式分娩镇痛可达到较好的镇痛效果,可缩短第1产程时间,不提高器械助产和剖宫产率,不影响新生儿Apgar评分.

The study intended to evaluate the efficacy and safety of patient-controlled intravenous analgesia with remifentanil for labor. Three hundred and two parturients at 37 -42 week of gestation received remifentanil （0. 1μg · kg-1 ·min-1 ） as patient-controlled intravenous analgesia for labor （analgesia group） and their clinical results were compared with those of 221 parturients in labor without intravenous analgesia （control group）. Maternal monitoring, including pain scores（VAS）, delivery mode, side effects, laboring time was performed for both groups. There was a significant decrease （P 〈0. 01） of pain scores in analgesia group compared with those in control group. Parturients in analgesia group experienced a significantly shorter first stage, than those in the control group （ P 〈 0. 01）. There were no differences between two groups in the rate of cesarean section and instrumental delivery. And there were no significant differences for newborns with Apgar scores less than 7 at the point of one minute. Patient-controlled intravenous analgesia with remifentanil for labor is an effective and safe procedure, which can significantly relieve pain, shorten first stage of labor and has no effect on the delivery mode and Apgar scores of neonates.