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[目的]比较两种不同给药方式下的分娩镇痛对初产妇第二产程的影响.[方法]本院要求行无痛分娩的初产妇32例,随机分为两组:每组16例.试验组采用小背景剂量大追加剂量的给药方式即8-2-20-8给药方式:给予首剂8 mL的罗哌卡因与芬太尼混合液后按2 mL/h混合液的速度持续输注背景剂量;另外,每20 min快速注入8 mL混合液.对照组采用大背景剂量小追加剂量的给药方式即86-20-3的给药方式:给予首剂8 mL的罗哌卡因与芬太尼混合液后按6 mL/h混合液的速度持续输注背景剂量;另外,每20 min快速注入3 mL混合液.两组分别于行无痛分娩前及第二产程评估疼痛评分(VAS评分),记录第二产程时长,测定婴儿乳酸值.[结果]两组产妇行无痛分娩前及第二产程的VAS评分、婴儿乳酸值相比较差异无显著性(P＞0.05);试验组产妇的第二产程时长明显短于对照组(P＜0.05).[结论]与传统的大背景剂量小追加剂量的给药方式比较,小背景剂量大追加剂量的给药方式可缩短初产妇第二产程的时长,且对婴儿无明显不良影响;是比较适合初产妇分娩镇痛时的给药方法.“,”[Objective]To compare the effects of two different ways of drug administrations in labor analgesia for primiparas during the second stage of labor time.[Methods]A total of 32 eases of primiparas who required painless childbirth were divided according to the random number table method into an experimental group and a control group,with 16 cases in each group.Primiparas in the experimental group were given anesthesia according to a high added dosage with low background dosage method also known as the 8-2-20-8 administration method:In the first dosage,patients were given 8 ml of a mixture of ropivacaine and fentanyl.The background dose was 2ml/h mixture.Every 20 minutes,an additional 8ml of the mixture was rapidly injected.Meanwhille,in the control group,primiparas were given anesthesia according to a low added dosage and high background dosage method also known as the 8-6-20-3 administration method:The ropivacaine and fentanyl mixture was given at a first dosage of 8ml.The background dosage was 6ml/h mixture.Every 20 minutes,an additional 3ml of the mixture was rapidly injected.VAS scores before labor analgesia and during the second stage of labor of the two groups of primiparas were evaluated,and the length of the second stage of labor was recorded.The lactate value of every infant was determined.[Results]The VAS scores of the two groups before labor analgesia and during the second stage and the lactate values of the infants showed no difference (P ＞0.05).The length of the second stage of labor in the experimental group was significantly shorter than that in the control group (P ＜0.05).[Conclusion]Compared to the high dosage of background and low additional dosage method of drug delivery,the low background dosage and high additional dosage method can shorten the length of the second stage of labor.It also has no obvious adverse reactions in babies.So,it is suitable as the method of delivery of labor analgesia for primiparas.