雷米芬太尼用于静脉自控分娩镇痛的效果

Outcomes of patient-controlled intravenous analgesia with remifentanil for labor

目的探讨雷米芬太尼用于产妇静脉自控分娩镇痛(PCIA)的临床效果。方法 60例初产妇随机均分为两组。R组实施雷米芬太尼PCIA:背景剂量0.02μg.kg-1.min-1+单次剂量10～20μg,锁定时间为3 min。C组未予镇痛作为对照。记录产程时间、分娩结局、疼痛和Ramsay镇静评分、不良反应、胎心率及新生儿Apgar评分。结果 R组镇痛镇静满意。R组产妇第一产程活跃期明显短于C组(P<0.05)。与C组比较,R组产妇镇痛期血压、心率下降显著(P<0.01)。两组的胎心、新生儿Apgar评分、产程时间和剖宫产率等指标均无明显差异。结论采用雷米芬太尼静脉自控分娩镇痛,可减轻分娩疼痛,对产妇产程和新生儿无明显影响。但要控制剂量,术中严密监测呼吸和循环功能。

Objective To evaluate the outcomes of patient-controlled intravenous analgesia（PCIA） with remifentanil for labor.Methods Sixty full term primiparas were equally randomized into two groups of R（PCIA with remifentanil 0.02 μg·kg-1·min-1 infusion and bolus doses of 10-20 μg in 3 min of lockout period） and C（treated without PCIA）.The vital signs,VAS pain and Ramsay sedation scores,duration of stages,delivery outcome,side effects,fetal heart rate（FHR） and neonatal Apgar scores were recorded.Results The analgesia and sedation during analgesia were satisfactory in group R.The active time of the first stage was shorter in group R than that in group C[（135.3±48.5） min vs.（327.2±35.9） min]（P0.05）.The SBP and HR during delivery were lower in group R than those in group C（P0.01）.There were no significant differences in duration of stages,Ceasarean section rate,FHR and neonatal Apgar scores between two groups.Conclusion PCIA with remifentanil is effective for labor analgesia without severe side effects on the maternal and neonate as long as properly selecting the dose and cerefully monitoring the vital signs.