分娩镇痛在产程中的应用探讨

Investigation of the application of labor analgesia in labor process

目的 探讨罗哌卡因与芬太尼联合自控硬膜外分娩镇痛的效果及对母儿的影响。方法 选择自愿要求分娩镇痛的480例产妇为镇痛组,以同期未实行分娩镇痛的480例产妇为对照组。比较两组产妇分娩时镇痛效果、产程时间、剖宫产率、缩宫素使用、新生儿窒息及产后出血情况。结果 镇痛组视觉模拟评分法(Visual Analogue Scale/Score,VAS)评分明显低于对照组(P<0.05),第一产程缩短、剖宫产率低,与对照组比较差异有统计学意义(P<0.05),但增加了缩宫素使用,两组新生儿窒息、产后出血量比较差异无统计学意义(P>0.05)。结论 罗哌卡因与芬太尼联合自控硬膜外分娩镇痛效果好,对母婴无不良影响,满足整个产程的需要,值得临床进一步推广应用。

Objective To discuss the effect of Ropivacaine and Fentanyl for patient controlled epidural analgesia in labor and its influence over mothers and infants. Methods 480 cases of voluntary labor analgesia were grouped as analgesia group, and other 480 parturients with no labor analgesia formed the control group in the same period. Comparison of analgesia effectiveness, duration of labor, rates of cesarean section, application of oxytocin, neonatal asphyxia and postpartum hemorrhage in two groups was made. Results The Visual Analogue Score （VAS） in analgesia group was significantly lower than that of the control group （ P 〈 0.05 ）. The first stage of labor and the cesarean section rate decreased with statistical significance （ P 〈 0. 05 ） in comparison with those of the control group, while the usage of oxytocin increased. The difference of neonatal asphyxia and postpartum hemorrhage in two groups was of no statistical significance （P 〉 0. 05 ）. Conclusion The application of Ropivacaine and Fentanyl for patient controlled epidural analgesia has good effectiveness with no adverse effects on mothers and infants. It meets well the needs in the whole labor process and is worthy of further application.