罗哌卡因复合芬太尼连续硬膜外阻滞自控麻醉对无痛分娩的临床观察

摘要

目的探讨硬膜外连续注射罗哌卡因和芬太尼应用于分娩镇痛的效果以及对产程过程和胎儿的影响.方法 选取2010年1月至2011年1月在我院自愿要求行分娩镇痛的60位足月单胎初产妇作为分娩镇痛组，给予0.2%罗哌卡因+0.5%芬太尼混合剂经硬膜外持续自控镇痛泵(PCEA)给药直至胎儿娩出，选择同期在我院未予任何处理经阴道分娩的60位足月单胎初产妇作为观察组，比较两组的镇痛效果、产程时间、分娩方式及新生儿Apgar评分(P>0.05).结果 两组的人口学特征、产程时间、分娩方式及新生儿Apgar评分差异无统计学意义(P<0.05)，分娩镇痛组的镇痛效果显著高于观察组，分娩镇痛组中有37.5%的产妇感觉无痛，明显高于观察组的12.5%，而观察组中有68.75%的产妇感觉中度疼痛，多于分娩镇痛组的12.5%，其差异具有统计学意义(P<0.05).结论 硬膜外连续注射罗哌卡因和芬太尼是一种有效安全的分娩镇痛方法，不增加总产程时间及剖宫产率，对母婴无不良影响.%　　Objective To evaluate the effect of fentanyl added to ropivacaine for epidural anesthesia in painless labor. Methods To choose 60 cases of voluntarily analgesic delivery from January 2010 to January 2011 in my hospital materials as analgesic delivery group, to gived they 0.2%  ropivacaine added 0.5% fentanyl for epidural anesthesia until fetal childbirth,select the same period has not been any treatment  vaginal delivery  as control group, The effect of anesthesia ,the time of labor duration , labormode and the neonatal Apgar score were Recorded.Results Two groups of demographic characteristics, the time of labor duration , labormode and neonatal Apgar score were no significant difference (P>0.05). the analgesic effect of analgesia group was significantly higher than the observation group,the difference was statistically significant (P<0.05).Conclusion Analgesia with fentanyl added to ropivacaine for epidural anesthesia is effective ,safe and reliable with not increase total time and cesarean section rate, and no side effect on maternal and infant.