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目的 :罗哌卡因复合芬太尼蛛网膜下腔—硬膜外联合阻滞麻醉在分娩镇痛中的临床疗效。方法 :收集我院分娩ASAⅠ～Ⅱ级初产妇 10 0例 ,随机分为两组各 5 0例。观察组为自愿要求镇痛无禁忌证产妇 ,采用罗哌卡因复合芬太尼蛛网膜下腔—硬膜外联合阻滞麻醉 ,连接微泵病人自控硬膜外镇痛 ;对照组为未使用分娩镇痛药物而进入产程的初产妇。观察比较两组产痛程度 ,产程时间 ,分娩方式 ,催产素使用 ,产时出血量和产妇生命体征 (Bp、P、R、SPO2 )和新生儿Apgar评分情况。结果 :两组比较观察组第二产程显著缩短 (P <0 0 5 ) ,剖宫产率降低 ,产程时间、产后出血量、催产素使用、新生儿Apgar评分产妇生命体征 (Bp、P、R、SPO2 )无显著差异 (P <0 .0 5 )。结论 :罗哌卡因复合芬太尼蛛网膜下腔—硬膜外联合阻滞麻醉用于分娩镇痛效果显著 ,用药量少 ,对母婴无影响 ,可缩短第二产程和减少剖宫产率
Objective: Ropivacaine combined with fentanyl subarachnoid - epidural anesthesia in labor analgesia clinical efficacy. Methods: One hundred and ten cases of ASA Ⅰ ~ Ⅱ primiparous in our hospital were randomly divided into two groups of 50 cases. The observation group was a voluntary contraindication analgesia without contraindication. Ropivacaine combined with fentanyl subarachnoid-epidural anesthesia was used in the observation group to control the patient’s self-controlled epidural analgesia. The control group was unused Labor analgesics and enter the labor process of primipara. The incidences of labor pain, labor duration, mode of delivery, oxytocin use, time of delivery, and maternal vital signs (Bp, P, R, SPO2) and neonatal Apgar scores were compared between the two groups. Results: Compared with the observation group, the second stage of labor was significantly shortened (P <0.05), the rate of cesarean section was reduced, the duration of labor, postpartum hemorrhage, oxytocin use, neonatal Apgar score of maternal vital signs (Bp, P, R , SPO2) no significant difference (P <0.05). Conclusion: Ropivacaine combined with fentanyl subarachnoid - epidural anesthesia for labor analgesic effect is obvious, less medication, no effect on mother and child, can shorten the second stage of labor and reduce cesarean section rate