罗哌卡因复合舒芬太尼应用于潜伏期分娩镇痛的临床效果

目的探讨0．125％罗哌卡因复合舒芬太尼用于潜伏期分娩镇痛的效果及对子宫收缩力的影响及新生儿阿氏评分情况。方法选择60例Ⅰ～Ⅱ级的足月初产妇，其中要求施行分娩镇痛的30例为观察组，另30例为对照组。观察组在进入产程潜伏期后进行腰-硬联合穿刺，见脑脊液流出后，缓慢注入小剂量的舒芬太尼20～25μg于蛛网膜下腔作为负荷剂量，300min后连接PCA泵以0．125％罗哌卡因1000ml与舒芬太尼50μg混合给予配制好的药液，胎儿娩出后停止硬膜外腔给药；对照组按产科常规处理。观察镇痛起效时间，子宫收缩力的变化，总产程、产后出血量、分娩结局及新生儿阿氏评分。结果观察组与对照组相比总产程无差异。第一产程中观察组于对照组相比子宫收缩力显著降低，P〈0．05，催产索使用率在80％以上。两组间产后出血、新生儿阿氏评分无显著差异。结论舒芬太尼合并低浓度的罗哌卡因应用于无痛分娩，有明显的分娩镇痛作用，镇痛效果确切，不影响产程及新生儿，不增加难产的比例不增加产后出血量，对新生儿的阿氏评分无影响。

Clinical effects of ropivacaine combined sufentanil for labor analgesia used in latent phase of the first stage of labor

Objective To evaluate the clinical effect of labor analgesia used in latent phase of the first stage of labor and effect on labor progress and Apgar score.Methods sixty foot early maternals who had no complications were randomly divided into 2 groups:experimental Group(whose labor analgesia was begun to use when the cervix was 1.0 cm dilated),control Group(control group who without use of labor analgesia).Analgesic effects were observed,changes of uterine contraction were recorded by fetal monitor.Meanwhile,total stage of labor,outcome of delivery and Apgar score were also recorded.Results Duration of total stage of labor had no significant differences between experimental group and control group.During the first stage of labor,uterine contraction power in experimental Group was significantly decreased that in control Group.The usage incidence of oxytocin was more than 80% in experimental Group.Postpartum hemorrhage and apgar score of newborn were no significant difference between 2 groups.Conclusion sufentanil combined with low concentration of ropivacaine for labor analgesia in the latent phase of first labor can reach the good effect and it does not increase postpartum hemorrhage and also has no effect on the apgar score of newborn.