低浓度罗哌卡因联合小剂量芬太尼连续硬膜外阻滞在无痛分娩中的效果

Effects of low-concentration ropivacaine combined with continuous epidural block of small dose of fentanyl on painless labor

目的探讨低浓度罗哌卡因联合小剂量芬太尼连续硬膜外阻滞在无痛分娩中的应用价值。方法选取2014年1月-2015年6月于我院分娩的100例初产妇为研究对象,其中68例初产妇自愿选择无痛分娩,作为观察组,其余32例初产妇作为对照组,观察两组产妇的疼痛情况、产程时间、产后出血和新生儿情况。结果观察组疼痛程度明显缓解;观察组第一产程时间为（180.5±61.7）min,短于对照组的（198.7±82.4）min（P〈0.05）,但两组第二、第三产程差异不大（P〉0.05）;两组新生儿Apgar评分差异不大（P〉0.05）;观察组产后2 h出血量为（190.1±21.1）mL,少于对照组的（200.4±22.1）mL（P〈0.05）。结论低浓度罗哌卡因联合小剂量芬太尼连续硬膜外阻滞用于分娩中,可缓解分娩疼痛,缩短第一产程时间,对母婴无严重影响,安全性较高,可作为无痛分娩的首选用药方法 。

Objective To explore the application value of low-concentration ropivacaine combined with continuous epidural block of small dose of fentanyl on painless labor.Methods One hundred primiparae labored in the hospital from January 2014 to June 2015 were selected as research subjects,68 primiparae of whom voluntarily chose painless labor,and they were divided into the observation group,and the remaining 32 primiparae were divided into the control group,the pain condition,delivery duration,postpartum hemorrhage and newborn status of lying-in women in two groups were compared.Results The pain intensity of primiparae in the observation group was obviously relieved;The first stage of labor of primiparae in the observation group hit（180.5±61.7） min,being shorter than that of patients in the control group at（198.7±82.4） min（P〈0.05）,but the difference in the second and third stages of labors of primiparae in two groups were not significant（P〉0.05）;The difference in Apgar scores of primiparae in two groups were not significant（P〉0.05）;The bleeding volume of primipare after 2 hours in the observation group hit（190.1 ±21.1） mL,being less than in that of primipare in the control group at（200.4±22.1） mL（P〈0.05）.Conclusion Low-concentration ropivacaine combined with continuous epidural block of small dose of fentanyl used in childbirth can relieve labor pain,shorten labor duration without serious effect on maternal and infant and high safety,being qualified as preferred medication methods for painless delivery.