罗哌卡因复合芬太尼硬膜外阻滞用于分娩镇痛的效果观察

目的 研究罗哌卡因复合芬太尼硬膜外阻滞用于分娩镇痛的效果及对母婴结局的影响.方法 选取2013年1月至2016年12月在新疆石河子市妇幼保健院住院分娩的单胎头位足月孕妇,分为两组:采用分娩镇痛者345例作为观察组,无分娩镇痛者776例作为对照组.结果 ①观察组产妇镇痛后各时间点疼痛数字评分(NRS)均较对照组降低,差异均有统计学意义(χ2值分别为-3.255、-6.135、-5.219、-7.139、-7.107,均P<0.05);②两组活跃期及二产程时间、新生儿阿氏评分、出血量比较差异均无统计学意义(t值分别为0.298、-0.375、0.189、0.693,均P>0.05);观察组缩宫素使用率高于对照组(χ2=37.921,P<0.05),观察组剖宫产率低于对照组(χ2=37.921,P<0.05).结论 罗哌卡因复合芬太尼硬膜外阻滞用于分娩镇痛可明显降低产妇疼痛,不延长产程,可降低剖宫产率,对母婴安全,值得推广应用.

Clinical effect observation of ropivacaine combining fentanyl for epidural anesthesia on labor analgesia

Objective To study the effect of fentanyl added to ropivacaine for epidural anesthesia on active labor and maternal and neonatal outcomes.Methods Single full-term pregnant women hospitalized in Xinjiang Shihezi Maternal and Children''s Health Care Hospital from January 2013 to December 2016 were selected and divided into two groups,345 cases with labor analgesia in observation group and 776 cases with usual delivery in control group.Results The NRS scores in each time point in the observation group was lower than that in the control group, and there was statistical difference between two groups (χ2 value was-3.255,-6.135,-5.219,-7.139 and-7.107, respectively, all P<0.05).No significant difference was found between two groups in active phase, the second stage of labor, newborn Apgar scoring and amount of bleeding(t value was 0.298,-0.375, 0.189 and 0.693, respectively, all P>0.05).The oxytocin utilization rate in the observation group was higher than that in the control group (χ2=37.921, P<0.05), but the cesarean section rate was lower (χ2=37.921, P<0.05).Conclusion Ropivacaine combining fentanyl for epidural anesthesia in active labor can relieve labor pain and reduce cesarean delivery rate without extending labor stage.It is safe for pregnant women and neonates and worthy of promotion.