异氟醚分娩镇痛的效果及其对母儿影响的研究

The effect of isoflurane inhalation analgesia on maternity and neonate in labor.

目的：探讨异氟醚用于第一产程活跃期镇痛的有效性及其对分娩、母体、胎儿和新生儿的影响。方法：将１００ 名初产妇随机分为Ａ、Ｂ、Ｃ、Ｄ组，分别为笑气异氟醚合用组、笑气组、异氟醚组及对照组，每组２５ 例；产妇采用半紧闭法间断吸入药物；以视觉模拟评分（ＶＡＳ）评价镇痛的效果；观察分娩各产程时间、分娩方式、产后出血、脐血血气分析及新生儿神经适应能力评分等；测定用药前后氟离子浓度。结果：用药后Ａ、Ｃ组的疼痛分数显著低于Ｂ组，Ａ、Ｃ两组间差异无显著性；其它各项指标四组间差异均无显著性。结论：吸入镇痛浓度的异氟醚或与笑气合用，是一种安全有效的镇痛法。

To study the analgesic efficiency of isoflurane for active term labor and its influence on labor,maternal,fetal and neonatal well?being.Methods:One hundred primiparae were divided randomly into four groups;group A,B,C,D received nitrous oxide and isoflurane in oxygen,nitrous oxide in oxygen,isoflurane in oxygen and air respectively (n=25).With semiclosed anesthetic method,the gases were inhaled intermittently by parturients.Effectiveness of analgesia was evaluated by visual analog scale(VAS).The time of each stage of labor,mode of delivery and pastpartum hemorrhage,gases analysis of umbilical blood and the Neonatal Neurologic Adaptive Capacity Score (NASS) were recorded.Maternal blood was analyzed for the concentration of fluoride ion before administration of analgesia and after delivery,the concentration of fluoride ion in umbilical blood.Results:VAS pain scores of group A and C after administration of analgesia were significantly lower than that of group B(P<0.05).There were no significantly difference between group A and C.No significantly differences in other parameters among the four groups.Conslusion:Isoflurane of subanesthetic concentration in oxygen or mixed with nitrons oxide,was a safe and effective inhalation analgesic agent for normal Vaginal delivery.