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目的:分析各种因素与分娩镇痛效果不良的相关性,从而为临床医生预测出现镇痛效果不良的可能性提供依据.方法:选择100例待产孕妇,在孕妇宫口开至2～7 cm时,取L3/4椎间隙硬膜外穿刺置导管,注入1.0%利多卡因,再连接镇痛泵,泵内药物为0.08%罗哌卡因及芬太尼2.5μg/ml,镇痛泵注药速度为(6～10)ml/hr.给予镇痛首量30min后用VAS评分(0～10分)评估镇痛效果,VAS>3分的产妇视为镇痛效果不良.记录各项指标:肥胖(BMI>30)、硬膜外麻醉失败史、孕次、孕周、催产素应用、硬外穿刺时宫口扩张≥7 cm、产程时间,麻醉者经验、阻力消失试验采用空气或生理盐水、放置导管不顺畅、局麻药容量、麻醉药物剂量和硬膜外镇痛时间.用X2检验进行单因素分析.结果:镇痛效果不良的产妇16人,占总人数的16.7%.单因素分析显示有硬膜外麻醉不成功史、宫颈扩张>7 cm、硬膜外置管不顺畅、产妇肥胖、产程时间、硬外镇痛时间、罗哌卡因的总量与镇痛效果不良有相关性(P<0.05).结论:部分产科和麻醉的因素增高了分娩镇痛效果不良的可能性,可通过改善这些因素提高分娩镇痛的成功率.“,”To analyze the correlation between a variety of factors and inadequate analgesia in delivery, provide evi-dence for predicting inadequate analgesia. Methods: 100 pregnant women delivering vaginally were studied. Epidural catheter was inserted in L3/4 interspace when cervical dilatation 2～7 cm. 1% lidocain was used for the initial bolus dose, 0. 08% ropivacain combined with 2. 5 μg/ml fentanyl were infused continuously at the rate of 6～10 ml/hour. 30 minutes after initial bolus, a visual analogue pain score (VAS) was carried out to evaluated the antalgic effect. Inadequate analgesia was defined as VAS≥3 in delivery. A variety of factors were recorded and analysed. Results: 18 pregnant women (16.7%) were found inadequate analgesia in delivery. Risk factors of inadequate analgesia in-eluded: analgesia failure history, cervical dilation≥7 cm, epidural difficult catheterization, obesity, duration of labor, analgesia time, dose of ropivacain (P<0. 05) . Conclusion: Several obstetrical and epidural-related factors increase the risk of inadequate epidural analgesia.