无痛分娩硬膜外阻滞麻醉中罗比卡因复合小剂量芬太尼应用效果及母婴结局分析

发布时间：2019-03-04 14:02

【摘要】：目的:探究罗比卡因复合小剂量芬太尼在无痛分娩硬膜外阻滞麻醉中的应用效果及母婴结局分析。方法:将宁海县妇幼保健院收治的261例初产妇作为研究对象,按接受无痛分娩与否分为观察组(135例)和对照组(126例)。采用罗比卡因复合小剂量芬太尼对观察组产妇实行硬膜外阻滞麻醉无痛分娩;对照组产妇则行自然分娩,不接受任何镇痛处理。就两组产妇的产程时间、分娩期间的VAS疼痛评分、新生儿Apgar评分、分娩方式以及产后并发症等临床资料进行对比分析。结果:观察组产妇的第一、二产程及总产程均短于对照组,在第一、二、三产程的VAS疼痛评分也均低于对照组(P0.05)。在出生后1min、5min、10min,两组新生儿的Apgar评分比较无明显差异(P0.05)。分娩方式上,观察组中自然分娩的产妇多于对照组,剖宫产的产妇小于对照组(P0.05),同时两组产妇在产后出血、尿潴留等并发症上也存在明显差异(P0.05)。结论:罗比卡因复合小剂量芬太尼在无痛分娩硬膜外阻滞麻醉上麻醉效果良好,能够明显缓解产妇的疼痛感,缩短产程,使自然分娩率得以提高,同时对新生儿的Apgar评分并无影响,值得在临床上推广应用。
[Abstract]:Objective: to investigate the effect of ropivacaine combined with low-dose fentanyl in epidural anesthesia of painless delivery and the analysis of maternal and infant outcomes. Methods: 261 cases of primipara admitted in Ninghai Maternal and Child Health Hospital were divided into observation group (135 cases) and control group (126 cases) according to whether they received painless delivery or not. Ropivacaine combined with low-dose fentanyl was used to perform epidural block anesthesia for painless delivery in the observation group and spontaneous delivery was performed in the control group without any analgesic treatment. The clinical data such as the duration of labor, the VAS pain score during delivery, the neonatal Apgar score, the delivery mode and the postpartum complications were compared and analyzed between the two groups. Results: the first, second and total labor stages in the observation group were shorter than those in the control group, and the VAS pain scores in the first, second and third stages of labor in the observation group were lower than those in the control group (P0.05). At 1 min, 5 min, 10 min after birth, there was no significant difference in Apgar scores between the two groups (P0.05). In the mode of delivery, the number of parturients in the observation group was more than that in the control group, and the cesarean section was smaller than that in the control group (P0.05). At the same time, there were significant differences between the two groups in postpartum hemorrhage, urinary retention and other complications (P0.05). Conclusion: ropivacaine combined with low dose fentanyl is effective in epidural anesthesia of painless delivery. It can obviously relieve the pain of parturients, shorten the labor process, and improve the rate of natural delivery. At the same time, it has no effect on neonatal Apgar score, and it is worth popularizing and applying in clinic.
【作者单位】：浙江省宁海县妇幼保健院麻醉科;
【分类号】：R714.3

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