罗哌卡因联合芬太尼用于产妇自控硬膜外分娩镇痛的疗效观察

目的:观察罗哌卡因联合芬太尼用于产妇自控硬膜外镇痛的疗效和安全性。方法:选择2008年1月-2009年6月来我院分娩的520例初产妇,其中接受0.125%罗哌卡因联合0.4%芬太尼2 mL硬膜外自控镇痛的260例产妇为镇痛组,条件相似而未接受分娩镇痛的260例产妇为对照组。比较2组产程、分娩方式、新生儿窒息例数、产后出血量。结果:2组第1、2、3产程和总产程比较,差异均无统计学意义(P>0.05),但镇痛组活跃期比对照组短(P<0.05),剖宫产率低于对照组(P<0.05);2组新生儿窒息、产后出血发生率比较均无显著性差异(P>0.05)。2组均未见严重不良反应发生。结论:罗哌卡因联合芬太尼用于产妇自控硬膜外镇痛安全有效,不良反应少,降低了剖宫产率。

Efficacy Observation of Ropivacaine Combined with Fentanyl in the Treatment of Puerpera Epidural Analgesia

OBJECTIVE： To evaluate the efficacy and safety of ropivacaine combined with fentanyl for puerpera epidural anal- gesia. METHODS： A retrospective study was conducted among 520 healthy primiparas, including 260 puerpera who received labor analgesia （0.125 % ropivacaine combined with 0.4% fentanyl 2 mL） in analgesia group and 260 without labor analgesia in control group. The duration, mode of delivery, the number of asphyxia neonatorum and postpartum hemorrhage were compared between 2 groups. RESULTS： There were no significant differences in the duration of the first, second, third or total labor stages between 2 groups（P〉0.05）, but the duration of the active stage was shorter in analgesia group than in control group（P〈0.05）. The rate of ce- sarean delivery was lower in analgesia group than in control group（P〈0.05）. There were no significant differences in the incidence of neonatal asphyxia and postpartum hemorrhage between 2 groups（P〉0.05）. There was no serious ADR found in 2 groups. CON- CLUSION： Ropivacaine and fentanyl is effective and safe for epidural analgesia and had few side effects. It also reduces the rate of cesarean delivery.