不同时机实施分娩镇痛对产程及分娩方式的影响

目的探讨在不同时机实施硬膜外分娩镇痛对产程的长短及分娩方式的影响。方法将愿意接受硬膜外分娩镇痛的足月初产妇180例随机分为两组：潜伏期组（A组,宫口〈3 cm）和活跃期组（B组,宫口〉3 cm）。硬膜外穿刺成功后,两组首剂给予0.125%罗哌卡因和0.5μg/ml舒芬太尼混合液10～15 ml,30 min后连接镇痛泵,背景剂量2 ml/h,追加剂量2 ml,锁定时间15 min。连续监测呼吸循环情况,采用视觉模拟疼痛评分（VAS）,并观察记录产程进展及分娩方式、产后出血量、新生儿Apgar评分、缩宫素使用情况、副作用及产妇满意度。结果两组镇痛后VAS评分均降低,与B组相比,A组潜伏期VAS评分明显降低（P〈0.05）,器械助产率升高（P〈0.05）,镇痛满意度升高,下肢麻木发生率升高（P〈0.05）。两组产程、剖宫产率、催产素使用量、产后出血量、新生儿Apgar评分无统计学差异（P〉0.05）。结论分娩早期实施椎管内麻醉镇痛不影响产程和剖宫产率,可提高孕妇对分娩镇痛的满意度,但器械助产率有所增高。

Effects of intrapartum analgesia at different stages on labor and mode of delivery

Objective To investigate the effects of intrapartum epidural analgesia at different stages on length of labor and mode of delivery.Methods 180 primiparas with termpregnancy who were willing to accept intrapartum epidural analgesia were randomly divided into two groups:latency group(group A)and active phase group(group B).Group A underwent the analgesia before the diameter of cervical opening was larger than 3 cm.Group B received the analgesia after the diameter of cervical opening reached to 3 cm.After succ...