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目的观察低浓度布比卡因复合芬太尼对镇痛分娩的效果及产程、母婴的影响。方法选择40例足月单胎、产前检查无阴道分娩禁忌,无椎管内硬膜外穿刺禁忌的初产妇,ASAⅠ~Ⅱ级,随机分为硬膜外阻滞作为镇痛组;自然分娩组作为对照组,每组20例。观察产妇的产程时间、分娩方式、镇痛效果(VAS)评分、下肢运动情况及新生儿Apgaer评分。结果硬膜外组对产妇的生命体征、产程、新生儿Apger评分与对照组相比差异无统计学意义(P>0.05);用产钳的几率比对照组增高且差异有统计学意义(P<0.05)。镇痛效果比对照组显著良好(P<0.01);运动不受影响,无感觉缺失,与对照组相比差异无统计学意义(P>0.05)。结论0.125%布比卡因复合芬太尼用于硬膜外分娩既能取得良好的镇痛效果,又能施行可行走的分娩镇痛,是一种较理想的用药方案。
Objective To observe the effects of low concentration bupivacaine and fentanyl on analgesia and delivery, maternal and infant labor. Methods 40 cases of term singleton fetus were selected. No prenatal vaginal birth taboo, no preterm epidural puncture epidural spinal anesthesia, ASA Ⅰ ~ Ⅱ grade were randomly divided into epidural block as analgesia group. Natural childbirth Group as a control group, 20 cases in each group. Obstetric time, delivery mode, analgesic effect (VAS) score, lower extremity motility and neonatal Apgaer score were observed. Results There was no significant difference between the epidural group and the control group in the vital sign, labor course and neonatal Apger score of the epidural group (P> 0.05). There was a significant difference between the epidural group and the control group (P < 0.05). The analgesic effect was significantly better than that of the control group (P <0.01). Exercise was not affected and no sensory loss was found. There was no significant difference between the two groups (P> 0.05). Conclusion 0.125% bupivacaine combined with fentanyl for epidural delivery can achieve both good analgesic effect, but also the implementation of walking labor analgesia is an ideal drug program.