连续硬膜外腔阻滞在分娩镇痛中应用

Application of Continuous Epidural Analgesia during Labor

目的:通过30例产妇应用连续硬膜外腔注药行分娩镇痛,观察镇痛效果及对宫缩、产程、宫口开大、儿头下降的影响,并行母血、脐血的血气分析。方法:在放置硬膜外腔管后产妇连续接受:(1)10 ml 0.125％布匹卡因,(2)10 ml 0.2％罗哌卡因,二者任选其一直至分娩。结果:注入初始量镇痛药后子宫收缩轻度抑制,持续10～15分恢复。此后在连续输注及第二产程中无宫缩抑制现象。结论:低浓度硬膜外腔阻滞麻醉,可缩短产程、使儿头下降及宫口扩张速率加快,降低产妇体力消耗,缓解胎儿循环系统,减少新生儿酸中毒发生率。

Objective:To observe the effects of continuous epidural analgesia during labor on uterine contraction,stages of labor,dilatation of cervix,descent of fetal head and blood gas analysis in mother and cord blood. Methods: After putting down an epidural catheter,each patient continuously received 10 ml of 0.125% bupivacaine or 10 ml of 0.2% lopicaine until the labor was over. Results: As the top-up dose was given, a mild depression of uterine activity lasting 10~ 15 minutes was noted. There was no depression of uterine activity during infusion period and second stage of labor. Conclusion:The continuous epidural analgesia during labor can shorten stages of labor,quicken rates of dilatation of cervix and descent of fell head,reduce mother's physical consumption,relieve fetal blood circulation and decrease the incidence of neonatal acidosis.