腰-硬联合麻醉配合导乐分娩镇痛效果及母婴安全性探讨

Effect of Patient-controlled Lumbar Epidural Combined Anesthesia with Doula for Labor Analgesia and Its Safety

目的观察罗哌卡因联合舒芬太尼经自控腰-硬联合麻醉配合导乐陪伴分娩镇痛效果,以及对产程和母婴的影响。方法随机选取自愿要求无痛分娩的产妇200例为观察组,另选择同期未使用任何分娩镇痛产妇200例为对照组,比较两组产妇分娩疼痛评分,产程时间,母儿血气结果及中转剖宫产、新生儿窒息、产后出血率。结果观察组分娩镇痛效果显著,剖宫产率低,与对照组比较差异有统计学意义(P<0.05),两组产程时间、产后出血、新生儿窒息率差异比较无统计学意义(P>0.05),血气分析结果观察组产妇及新生儿氧分压比对照组高,而二氧化碳分压比对照组低,其差异比较有统计学意义(P<0.05)。结论罗哌卡因复合舒芬太尼用于自控腰-硬联合麻醉配合导乐陪伴分娩镇痛效果确切,安全可靠,中转剖宫产率低,对母儿无明显不良影响。

Objective To explore the effect of patient - controlled lumbar epidural combined anesthesia with Doula for labor analge- sia with ropivacaine and sufentanil, and its influence on the progress of labor,outcomes of mother and infant. Methods Two hundred par- turients that requested labor analgesia were randomly selected by patient - controlled lumbar epidural combined anesthesia with Doula as the observation group,meanwhile another 200 parturients were selected as the control group without any analgesic measurements. Labor pain score, labor duration, blood gas analysis results and the incidence of cesarean section, neonatal asphyxia and postpartum hemorrhage were compared between the two groups. Results Compared with the control group, labor analgesia effect was remarkable, and the cesare- an section rate was significantly reduced. PO2 were higher and PCO2 for maternal and neonatal blood gas results were lower than those in control group, and the difference was statistically significant（ P 〈 0.05 ）. But in duration of labor, maternal, postpartum hemorrhage, neo- natal asphyxia, there were no statistical significance between two groups （ P 〉 0.05 ）. Conclusion Labor analgesia by patient - controlled lumbar epidural combined anesthesia companied Doula with ropivacaine and sufentanil is effective, safe and reliable, has un - adverse effects and reduce cesarean section rate.