罗哌卡因复合舒芬太尼硬膜外麻醉和腰硬联合阻滞麻醉用于无痛分娩的临床观察

Clinical Observation of Ropivacaine Sufentanil Epidural Anesthesia and Combined Spinal Epidural Block Anesthesia for Painless Childbirth

目的：观察罗哌卡因复合舒芬太尼硬膜外麻醉和腰硬联合阻滞麻醉在无痛分娩中的应用及疗效。方法 选取了2013－01～2014－02间我院产科门诊82例足月、头位、单胎且自愿接受无痛分娩孕妇，按照随机原则将其分为对照组和观察组，每组各41例，其中对照组采用罗哌卡因复合舒芬太尼硬膜外麻醉，观察组给予罗哌卡因复合舒芬太尼腰硬联合阻滞进行麻醉。同时，对产妇分娩时间、疼痛评分、下肢肌力以及新生儿Apart评分、产妇生命体征、不良反应等进行观察记录。结果 两组产妇在生命体征、新生儿Apart评分以及下肢肌力上比较无显著差异。而在产程、产妇疼痛评分以及护理满意度等指标上，观察组显著好于对照组，差异具有统计学意义（ P＜0．05）。结论 在产妇无痛分娩的过程中，罗哌卡因复合舒芬太尼腰硬联合阻滞麻醉见效快，产程短，镇痛效果显著，患者满意度高，值得在临床上进行推广和应用。

Objective To observe the ropivacaine sufentanil epidural anesthesia and combined spinal block anesthesia application and efficacy in painless childbirth.Methods Selecting 82 cases with obstetric clinics term, cephalic, singleton pregnancies and voluntary ac-ceptance of painless childbirth pregnant from January, 2013 to February, 2014 in the hospital, and randomly dividing them into control group and observation group, with 41 cases in each group.Ropivacaine combined with sufentanil epidural anesthesia （ CEA） was used in the control group, and ropivacaine combined with sufentanil epidural block （ CSEA） anesthesia was used in the observation group.Mean-while, maternity time, pain scores, lower extremity muscle strength and neonatal Apart score, maternal vital signs, adverse reactions were observed and recorded.Results There were no significant differences in maternal vital signs of mothers, neonatal apart ratings and lower extremity muscle strength in two groups.In the production process, maternal pain scores and nursing satisfaction and other indicators, the observation group was significantly better than the control group, and the difference was statistically significant contrast （P〈0.05）.Con-clusion In the process of painless delivery, maternal ropivacaine combined with sufentanil epidural block is quick, and has short labor process.Its analgesic effect is significant, with high patient satisfaction.So it is worth promotion and application in clinical practice.