目的探讨舒芬太尼联合不同浓度罗哌卡因行阶梯式分娩镇痛对产程进展和新生儿的影响。方法选取2013年2月~2014年5月间在该院住院待产的足月单胎妊娠初产妇190例,随机分为对照组和阶梯镇痛组,每组各95例。对照组始终给予0.5μg/ml舒芬太尼联合0.15%的罗哌卡因进行治疗;阶梯镇痛组在分娩潜伏期给予0.5μg/ml舒芬太尼联合0.075%的罗哌卡因,活跃期给予0.5μg/ml舒芬太尼联合0.15%的罗哌卡因。比较两组产妇各时间段的视觉模拟(VAS)评分、镇痛起效时间、缩宫素使用情况、各产程时间、产妇Bromage评分、不良反应情况,以及出生后1 min、5 min、10 min的新生儿Apgar评分。结果对照组和阶梯镇痛组各时间段VAS评分和镇痛起效时间之间差异均无统计学意义(P>0.05)。阶梯镇痛组产妇缩宫素使用率明显低于对照组产妇,分娩潜伏期明显短于对照组产妇,差异均有统计学意义(P<0.05);分娩活跃期、第二产程、第三产程两组产妇持续时间组间差异无统计学意义(P>0.05)。阶梯镇痛组产妇Bromage评分为0分的比例明显高于对照组产妇,差异有统计学意义(P<0.05)。两组新生儿出生后1 min、5 min、10 min的Apgar评分组间差异均无统计学意义(P>0.05);两组产妇均未出现麻醉镇痛相关不良反应。结论阶梯镇痛法对产妇宫缩和产程的影响小,对新生儿健康无影响,可在临床中推广应用。 Objective To investigate the effects of sufentanil combined with different concentrations of ropivacaine on labor progress and newborns. Methods 190 cases of full-term singleton pregnancies in hospital from February 2013 to May 2014 were randomly divided into control group and step analgesia group, 95 cases in each group. The control group was given 0.5μg / ml sufentanil combined with 0.15% ropivacaine for treatment. In the step-analgesia group, 0.5μg / ml sufentanil combined with 0.075% ropivacaine was given in the incubation period. The active phase 0.5 μg / ml sufentanil plus 0.15% ropivacaine was given. Visual analogue (VAS) score, time to onset of analgesia, use of oxytocin, duration of labor, maternal Bromage score and adverse reactions were compared between the two groups in terms of visual analogue (VAS), postnatal 1 min, 5 min, 10 min Apgar score for newborns. Results There was no significant difference between VAS score and analgesic onset time in control group and step analgesia group at each time point (P> 0.05). The use rate of oxytocin in step analgesia group was significantly lower than that in control group, and the latent period of childbirth was significantly shorter than that in control group (P <0.05). The active labor period, second and third labor There was no significant difference in the duration of maternal group between groups (P> 0.05). The rate of maternal Bromage score was 0 in step analgesic group was significantly higher than that in control group (P <0.05). There was no significant difference in Apgar score between two groups at 1 minute, 5 minutes and 10 minutes after birth (P> 0.05). No analgesia-related adverse reactions occurred in both groups. Conclusion The method of ladder analgesia has little effect on uterine contraction and labor process, has no effect on the health of newborn and can be widely applied in clinic.