罗哌卡因与舒芬太尼硬膜外自控分娩镇痛效果观察

目的探讨罗哌卡因与舒芬太尼硬膜外自控用于分娩镇痛的效果。方法400例住院分娩产妇，未实施分娩镇痛者200例为对照组，应用罗哌卡因与舒芬太尼硬膜外自控镇痛者200例为镇痛组，比较2组规律宫缩镇痛前、宫缩活跃期、第二产程、缝合会阴伤口时VAS评分，第一及第二产程时间，产后出血量，催产素应用率及剖宫产率，胎儿窘迫及新生儿窒息发生率。结果镇痛组宫缩活跃期、第二产程、缝合会阴伤口时VAS评分低于对照组（P〈0．05）；镇痛组活跃期时间、剖宫产率低于对照组（P〈0．05），催产素应用率高于对照组（P〈0．05）；2组第二产程时间、产后出血量、胎儿窘迫及新生儿窒息发生率差异无统计学意义（P〉0．05）。结论分娩时应用罗哌卡因与舒芬太尼硬膜外自控镇痛效果满意，且不增加胎儿窘迫及新生儿窒息发生率。

Observation of patient-controlled epidural analgesia with the combination of ropivacaine and sufentanil

Objective To investigate the effect of patient-controlled epidural analgesia （PCEA） with the combination of ropivacaine and sufentanil on labor. Methods A total of 400 patients of delivery in hospital were selected and randomly divided into two groups, with 200 patients in each group. Analgesia group underwent PCEA with the combination of ropivacaine and sufentanil, and control group did not receive analgesia. The VAS scores, labor stage, post-partum hemorrhage volume, oxytocin application, cesarean section rate, and incidences of fetal distress and asphyxia neonatorum in different stages were observed and compared between two groups. Results The VAS scores in the active stage of labor, the second stage of labor and the sutures of the perineum, duration of active stage, and the cesarean section rate were significantly lower in analgesia group than those in control group （P~0.05）, and the rate of oxytocin application was significantly higher in analgesia than that in control group （P〈0.05）. There were no significant differences in the time of the second stage of labor, post-partum hemorrhage volume, the incidences of fetal distress and asphyxia neonatorum between two groups （P〉0.05）. Conclusions PCEA with the combination of ropivacaine and sufentanil can achieve a satisfactory result and does not increase the incidence of fetal distress and asphyxia neonatorum.