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目的探讨雷米芬太尼静脉分娩镇痛效果及其对新生儿的影响。方法 100例自然分娩初产妇随机均分为观察组和对照组。观察组施行雷米芬太尼静脉镇痛,镇痛药:雷米芬太尼1mg用生理盐水稀释至50ml,负荷量为泵内溶液1ml,背景剂量5ml/h,PCA剂量1ml,锁定时间3min;持续至宫口开全。对照组不用分娩镇痛药物。比较两组产妇宫缩VAS疼痛评分,记录产妇满意度评分、新生儿Apgar评分和不良反应。胎儿娩出后取脐动脉血行血气分析。结果观察组VAS疼痛评分低于对照组[(1.35±0.88)分vs.(8.52±0.93)分](P<0.05);观察组满意度评分高于对照组[(8.92±0.65)分vs.(2.25±0.55)分](P<0.05)。两组均无发生心律失常、呼吸抑制、恶心呕吐、皮肤瘙痒及头晕、嗜睡等不良反应。两组新生儿1-min Apgar评分[(9.6±0.4)分vs.(9.5±0.5)分]和脐动脉血气分析指标相仿(P>0.05)。结论雷米芬太尼静脉分娩镇痛安全有效,不良反应少,对新生儿无不良影响。
Objective To investigate the analgesic effect of intravenous leifentanyl in labor and its effect on neonates. Methods 100 cases of primiparous spontaneous birth were randomly divided into observation group and control group. The observation group was administered remifentanil intravenous analgesia, analgesics: remifentanil 1mg diluted with saline to 50ml, the load of the pump solution 1ml, the background dose of 5ml / h, PCA dose of 1ml, lock time 3min Continue until the cervix opened. Control group without labor analgesics. VAS pain scores were compared between the two groups. The maternal satisfaction score, neonatal Apgar score and adverse reactions were recorded. Fetal blood samples taken after umbilical artery blood gas analysis. Results The score of VAS pain in the observation group was lower than that of the control group [(1.35 ± 0.88) vs (8.52 ± 0.93)] (P <0.05). The satisfaction score of the observation group was higher than that of the control group [(8.92 ± 0.65) vs. (2.25 ± 0.55) points (P <0.05). No arrhythmia, respiratory depression, nausea and vomiting, pruritus and dizziness, drowsiness and other adverse reactions occurred in both groups. The 1-min Apgar score [(9.6 ± 0.4) vs. (9.5 ± 0.5) points] in both groups was similar to that of umbilical artery blood gas analysis (P> 0.05). Conclusion Remifentanil intravenous labor analgesia safe and effective, less adverse reactions, no adverse effects on newborns.