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目的:探讨低浓度罗哌卡因复合舒芬太尼在分娩镇痛中的应用效果,及对产程和母婴安全的影响。方法:选择自愿接受分娩镇痛ASAⅠ～Ⅱ级待产初产妇,自愿接受分娩镇痛的初产妇50例作观察组(罗哌卡因200 mg+舒芬太尼20μg+格拉司琼0.3 mg+生理盐水,总量为100 ml,以2 ml/h连续硬膜外自控镇痛),与同期内同等条件下,未施任何分娩镇痛的初产妇50例作为对照组。对镇痛效果、孕妇的疼痛评分及活跃期、第二、第三产程时间、分娩方式、新生儿Apgar评分及产后出血情况进行评定,比较两组产程中的不良反应。结果:与对照组比较,观察组各时点VAS评分均显著下降(P<0.01),观察组的活跃期较对照组显著缩短(P<0.01),宫缩痛明显减轻,产妇满意,可在家属的陪护下地行走。结论:低浓度罗哌卡因复合舒芬太尼分娩镇痛效果确切,利于产程进展,对母婴安全,值得临床推广应用。
Objective: To investigate the effect of low concentration ropivacaine combined with sufentanil in labor analgesia, and its effects on labor process and maternal and infant safety. Methods: Fifty primiparous women who volunteered for labor analgesia ASA Ⅰ ~ Ⅱ were randomly assigned to receive labor analgesia for observation group (200 mg ropivacaine + 20 μg sufentanil + 0.3 mg + granisetron hydrochloride + The amount of 100 ml to 2 ml / h continuous controlled epidural analgesia), with the same period under the same conditions, did not give any labor analgesia primipara 50 cases as a control group. The analgesic effect, pain scores of pregnant women and the active period, the second and third stage of labor time, mode of delivery, neonatal Apgar score and postpartum hemorrhage were assessed, and the adverse reactions in the two groups were compared. Results: Compared with the control group, the VAS score of the observation group decreased significantly at each time point (P <0.01), the active phase of the observation group was significantly shorter than that of the control group (P <0.01), the contraction of the uterine contraction was significantly reduced, and the maternal satisfaction was Family members accompany walking. Conclusion: Low concentration of ropivacaine combined with sufentanil is effective in analgesia during labor and is beneficial to the progress of labor. It is worthy of clinical promotion and application for the safety of mother and infant.