瑞芬太尼两种静脉自控镇痛方式与硬膜外自控镇痛用于孕妇镇痛分娩的临床观察

Clinical Observation on Two Patterns of Patient-Controlled Intravenous Analgesia with Remifentanil and Patient-Controlled Epidural Analgesia in Pregnant Women with Labor Analgesia

目的分析孕妇镇痛分娩采用瑞芬太尼行不同静脉自控镇痛(PCIA)方式以及硬膜外自控镇痛(PECA)的效果。方法154例行镇痛分娩的孕妇按镇痛方法的不同分组,观察1组(51例)给予瑞芬太尼静脉单次给药,观察2组(51例)给予瑞芬太尼静脉泵持续输注,观察3组(52例)给予PECA,比较三组产妇的疼痛评分及新生儿Apgar评分,统计产妇的各产程时间及阴道助产、剖宫产比例。结果用药后,三组的疼痛评分均降低,且观察3组的疼痛评分低于其他两组(P<0.05)。三组产后1 min、5 min的新生儿Apgar评分比较无显著差异(P>0.05)。观察2组的第一、第二产程用时均短于其他两组(P<0.05)。结论孕妇分娩镇痛采用瑞芬太尼行静脉自控持续输注,分娩期间的镇痛效果、新生儿评分良好,产妇产程明显缩短。

Objective To analyze the effects of remifentanil on different patterns of patient-controlled intravenous analgesia(PCIA)and patient-controlled epidural analgesia(PECA)in pregnant women with labor analgesia.Methods 154 pregnant women with labor analgesia were divided into three groups according to analgesic methods.51 cases in group 1 received single intravenous administration of remifentanil,51 cases in group 2 received continuous infusion of remifentanil by intravenous pump,and 52 cases in group 3 received PECA.The maternal pain score and Apgar score of newborn were compared among 3 groups,and the duration of labor and the proportions of vaginal delivery and cesarean section were counted.Results After medication,the pain scores of the three groups decreased,and the pain score of group 3 was lower than that of the other two groups(P<0.05).No significant difference was found in the postpartum 1-min and 5-min neonatal Apgar scores among the three groups(P>0.05).The duration of the first stage and second stage of labor in group 2 were shorter than those in the other two groups(P<0.05).Conclusions Continuous patient-controlled intravenous infusion with remifentanil applied in pregnant women with labor analgesia has good analgesic effect and neonatal score during delivery,and significantly shortened labor process.