全程硬膜外分娩镇痛对第二产程及分娩方式的影响

The influence of continuous epidural labor analgesia on second stage of labor and method of delivery

目的观察全程硬膜外分娩镇痛对第二产程及分娩方式的影响。方法选择要求硬膜外分娩镇痛的产妇449例,当镇痛效果确切,进入第二产程后分别给予罗哌卡因复合舒芬太尼(持续镇痛组,R组,n=287)或生理盐水(暂停镇痛组,N组,n=162)。胎儿娩出后,比较两组产妇的产程时间、分娩方式、产程镇痛满意度、会阴部修复时VAS评分。结果两组产妇第二产程时间及分娩方式差异无统计学意义;R组产妇第二产程镇痛满意度(91±6)分,明显高于N组(84±7)分(P<0.05),而R组会阴部修复时VAS评分为(0.7±0.6)分,明显低于N组(1.2±0.8)分(P<0.05)。结论全程硬膜外分娩镇痛对第二产程及分娩方式无明显影响,而且第二产程及会阴部修复时镇痛满意度较高。

Objective To observe the influence of continuous epidural labor analgesia on second stage of labor and method of delivery. Methods Four hundred and forty-nine parturients, who received epidural labor analgesia were assigned into continuous ropivacaine combined sufentanil analgesic group （group R, n = 287） and normal saline group （group N, n = 162） during second stage of labor. Duration of labor, method of delivery, maternal satisfaction, as well as pain score during perineal trauma repair were evaluated after delivery. Results Compared with group N, duration of second stage of labor and method of delivery had no significant difference in group R. However, maternal satisfaction in the second stage of labor was significantly higher in group R compared with that in group N [（84±7） vs. （91±6）] （P〈0. 05）. Otherwise, VAS score during perineal trauma repair was significantly lower in group R compared with that in group N [（0.7 ±0.6） vs. （1.2 ±0.8）] （P〈0.05）. Conclusion Continuous epidural labor analgesia has no influence on second stage of labor and method of delivery, however, the analgesic satisfaction for second stage of labor and perineal trauma repair are significantly higher.