瑞芬太尼静脉自控性镇痛用于分娩镇痛的效果

Effect of patient controlled intravenous analgesia with remifentanil for labor analgesia

目的分析产妇分娩过程中行瑞芬太尼静脉自控性镇痛的效果,并评定其临床不良反应。方法选取自愿行分娩镇痛的60例产妇作为本次研究组,产妇进入产程后如宫缩疼痛则加入瑞芬太尼静脉自控性镇痛;选取同期行导乐分娩的产妇60例作为参照组。比较两组产妇的疼痛程度、产程时间、剖宫产率、产后出血量不良反应发生情况及临床指标。结果研究组产妇的阵痛总有效率明显高于参照组(P<0.05);两组产妇产程时间、剖宫产率、产后出血量和不良反应总发生率比较,无显著差异(P>0.05);研究组产妇T_2和T_3的VAS评分、RR、MAP均明显低于参照组产妇(P<0.05);T2研究组产妇的宫缩强度明显弱于参照组(P<0.05),T3研究组产妇的宫缩强度与参照组比较,无显著差异(P>0.05);研究组产妇T_2和T_3的HR、胎心率与参照组比较,无显著差异(P>0.05)。结论瑞芬太尼静脉自控性镇痛用于产妇分娩镇痛效果显著,对临床研究具有重要作用。

Objective To analyze the patient controlled intravenous analgesia with remifentanil for labor analgesia and evaluate its clinical adverse reactions. Methods Sixty pregnant women with voluntary labor analgesia were selected as the study group. If the pregnant women had pain from uterine contractions, the patient controlled intravenous analgesia with remifentanil was given to them. Sixty cases of pregnant women with doula delivery at the same period were selected as the reference group. The pain degree, labor time, cesarean section rate, postpartum hemorrhage, incidence of adverse reactions and the clinical index were compared between the two groups. Results The total analgesia rate in the study group was significantly higher than that in the reference group（P〈0.05）. There were no significant differences in the labor time, cesarean section rate, postpartum hemorrhage and incidence of adverse reactions between the two groups（P〈0.05）. The VAS score,RR and MAP at T2 and T3 of the study group were obviously lower than those of the reference group（P〈0.05）. At T2, the strength of uterine contraction in the study group was obviously weaker than that in the reference group（P〈0.05）, and there was no difference in the strength of uterine contraction between the two groups at T3（P〉0.05）. There were no significant differences of HR and fetal heart rate between the two groups at the stage of T2 and T3（P〉0.05）. Conclusion The patient controlled intravenous analgesia with remifentanil has significant effect on labor analgesia, which plays an important role in clinical research.