瑞芬太尼自控镇痛泵对分娩的镇痛作用及对产程的影响

Effects of remifentanil patient-controlled analgesia pump on labor analgesia and stages of labor

目的:探讨瑞芬太尼自控镇痛(PCA)泵对头位分娩初产妇的镇痛作用及对产程的影响。方法:选择2013年1月至2015年12月间于我院住院分娩的产妇240例,分为瑞芬组(选择瑞芬太尼PCA泵分娩镇痛)、笑气组(选择N_2O分娩镇痛)及空白组(常规产程护理无分娩镇痛)各80例,比较3组产妇宫缩痛及产程时限的差异。结果:瑞芬组无行剖宫产者,该组镇痛15、30 min及宫口开全时VAS评分明显低于空白组,镇痛30 min及宫口开全时VAS评分明显低于笑气组,差异有统计学意义(P<0.05);瑞芬组活跃期和总产程时限低于笑气组和空白组,差异有统计学意义(P<0.05)。结论:产妇宫口开大4 cm以上应用瑞芬太尼PCA泵能明显减轻分娩剧痛,减少产妇体力消耗,缩短产程。

Objective： To study the effects of remifentanil patient-controlled analgesia（ PCA） pump on labor analgesia and stages of labor in pimiparas＇ head-position delivery. Methods： Two hundred and forty puerperas treated in Obstetrics Department of Weifang Traditional Chinese Medicine Hospital from Jan. 2013 to Dec. 2015 were selected for this study,and they were divided into remifen group（ with remifentanil patient controlled analgesia pump）,N_2 O group（ with N_2O） and blank group（ routine care without analgesia treatment） with 80 in each group.The difference of pain of uterus systole and duration of labor stages between the three groups was compared.Results： No cesarean section was performed in remifen group,and VAS score of analgesia at 15 min,30 min and at the time of full cervical dilation was significantly lower than that of the blank group. VAS score of analgesia at 30 min and at the time of full cervical dilation in remifen group was significantly lower than that of N_2 O group with statistically significant difference（ P〈0. 05）. The active period and total stage of labor in Remifen group were lower than those in the N_2 O group and blank group,the difference being statistically significant（ P〈0. 05）.Conclusion： Application of remifentanil PCA pump in puerperas with cervical dilation over 4 cm can significantly relieve labor pain,reduce physical energy consumption and shorten the stage of labor.