两种硬膜外分娩镇痛给药方式效果比较

目的观察两种硬膜外分娩镇痛给药方式对产妇镇痛满意度的影响。方法将60例ASAⅠ~Ⅱ级有分娩镇痛要求的初产妇随机分为Ⅰ组和Ⅱ组各30例,两组均在成功实施硬膜外阻滞后,将硬膜外导管与镇痛泵相连;Ⅰ组设定无背景剂量,Ⅱ组设定背景剂量5 ml/h;均设置单次剂量5 ml,锁定时间15 min。结果两组产妇在分娩镇痛期间的BP、HR、RR、SpO2、胎心率及宫缩强度均在正常范围,各记录时点的VAS评分、不良反应发生率及产妇满意度两组差异无统计学意义(均P>0.05);Ⅰ组行PCEA单次剂量追加例数和按压次数均显著多于Ⅱ组(均P<0.01),使用罗哌卡因和舒芬太尼药量显著少于Ⅱ组(均P<0.01)。结论两种给药方式均能使产妇达到较高满意度,有背景剂量的给药方式接近理想分娩镇痛效果。

Comparison of two administration methods for epidural analgesia during labor

Objective To explore effects of two administration methods for epidural analgesia on analgesic satisfaction during labor.Methods Sixty ASA Ⅰ or Ⅱ primiparas who requested labor analgesia were randomized into two groups,with 30 cases in each group.The 2 groups started identical epidural block,then groupⅠreceived patient controlled epidural analgesia（PCEA） without background infusion（demand dose=5 ml each time,lock-out interval=15 min）,additionally groupⅡreceived 5 ml/h background infusion.Results The BP,HR,RR,SpO₂,uterine contraction,FHR were in normal range in both groups;there were no significant differences in VAS score,incidence of side effects and patient satisfaction between the 2 groups at uaried time points（P>0.05 for all）.The number of demands for physician-administered supplementation and use of PECA were much more in group Ⅰ（P<0.01 for both）,the cumulative ropivacaine and sufentanil use in groupⅠ were significantly less than group Ⅱ（P<0.01 for both）.Conclusion The two administration methods for epidural analgesia can achieve satisfactory analgesic effect during labor,and the use of background infusion with PCEA is the ideal analgesia for labor.