Objective To observe the clinical effect and safety of intravenous remifentanil combined with epidural block for labor anal-gesia. Method Sixty full-term Primipara were randomly divided into two groups(n=30):group E and group R. In group E,the parturients were given epidural analgesia when when cervical dilatation reached 3 cm;in group R,0. 05μg( kg·min)remifentanil were contious intra-venous infused at the beginning of epidural analgesia. Visual analogue scale( VAS)was used to record pain scores before analgesia and at different time points after analgesia;the duration of labor,incidence of caesarean delivery,instrumental vaginal delivery and oxytocin admin-istration ,neonatal Apgar scores ,umbilical cord arterial blood gas parameters and side effects of analgesia were recor-ded. Results Compared with group E,the VAS score were decreased in group R at every time points after analgesia(P<0. 05). There were no significant difference between the two groups in the duration of labor,incidence of caesarean delivery、instrumental vaginal delivery and oxytocin administration ,neonatal Apgar scores ,umbilical cord arterial blood gas parameters and side effects of analgesia(P>0. 05). Con-clusion Intravenous infusion of remifentanil can improve analgesia effect of Epidural Analgesia for Labor and does not increase the inci-dence of its side effects.%目的：观察静脉输注瑞芬太尼复合硬膜外阻滞用于分娩镇痛的临床效果和安全性。方法：选择足月初产妇60例，随机分为硬膜外镇痛组（ E组）和瑞芬太尼复合硬膜外镇痛组（ R组），每组30例。E组宫口开至3 cm时行硬膜外阻滞分娩镇痛。R组在硬膜外给药同时静脉泵入瑞芬太尼，泵注剂量0.05μg/（ kg·min）。记录镇痛前及镇痛后各时间点产妇视觉模拟评分法（ VAS）的评分；记录产程时间、剖宫产率、器械助产率、缩宫素使用率；记录新生儿Apgar评分，同时抽取脐动脉血行血气分析；观察分娩过程中的不良反应。结果：R组镇痛后各时间点VAS评分均低于E组，差异有统计学意义（ P<0.05）；两组产妇产程时间、剖宫产率、器械助产率、缩宫素使用率、新生儿Apgar评分、脐动脉血气分析及分娩过程中不良反应发生率比较差异均无统计学意义（ P>0.05）。结论：静脉输注瑞芬太尼可以明显改善硬膜外阻滞分娩镇痛的镇痛效果，并不增加其不良反应的发生。
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