曲马多联合罗哌卡因用于分娩镇痛的临床分析

Clinical Analysis of Tramadol Combined with Ropivacaine for Labor Analgesia

目的探讨曲马多联合罗哌卡因连续硬膜外麻醉用于无痛分娩的效果及对产程的影响。方法回顾该院2011年6—7月收治的750例曲马多联合罗哌卡因连续硬膜外麻醉行无痛分娩的病例材料,对照组随机选取同一时期未行无痛分娩的产妇50例,比较组中产妇的剖宫产率、疼痛程度及产程差异无统计学意义。结果无痛分娩组剖宫产率6%低于对照组28%;疼痛方面,分娩过程中分娩镇痛组疼痛评分(2.5±0.4)分明显轻于对照组(7.5±0.7)分,但缝合会阴切口时2组差异无统计学意义;对产程影响方面,活跃期分娩镇痛组时间(146±20)min短于对照组(247±25)min,而第二产程分娩镇痛组时间(80±16)min长于对照组(53±18)min。结论曲马多联合罗哌卡因行连续硬膜外麻醉无痛分娩效果更加安全。

Objective To investigate the effect of tramadol combined with mpivacaine continuous epidural anesthesia on painless labor and the duration of labor. Methods The data of 50 eases underwent painless labor with tramadol combined with ropivacaine continuous epidural anesthesia in 2011 from June to July were reviewed. And 50 cases did not undergo painless labor during the same period were selected as the control group. The rate of cesarean section, level of pain and duration of labor were compared between the two groups. Results The rate of cesarean section of the painless labor group was 6%, lower than 28% of the control group; the pain score during labor in the labor analgesia group was （2.5±0.4） points, much lower than （7.5±0.7） points of the con- trol group, but the difference in pain score between the two groups was not significant when suturing the perineal incision. The duration of active stage of the labor analgesia group was （146±20）min, shorter than （247±25）min of the control group, while the duration of the second stage of labor of the labor analgesia group was （80±16）min, longer than （53±18）min of the control group. Conclusion Tramadol combined with ropivacaine continuous epidural anesthesia is safe and effective for painless labor.