腰麻-硬膜外联合阻滞麻醉用于分娩镇痛的临床分析

目的探讨蛛网膜下腔-硬膜外联合阻滞麻醉（CSEA）进行分娩镇痛对母儿的影响。方法将200例（试验组）无产科并发症和麻醉禁忌证的初产妇分为自然临产组120例，缩宫素引产组80例；随机抽取同期条件相当，未实施分娩镇痛者200例也分别与镇痛组配为对照组，试验组在活跃初期使用小剂量低浓度麻醉药经蛛网膜下腔-硬膜外联合给药，观察用药后不良反应和镇痛效果以及对产程时间、分娩方式、产后出血、新生儿窒息、羊水性状的影响，并与200例对照组产妇相比较。结果试验组镇痛效果良好，未见明显不良反应，活跃期和第二产程缩短，此镇痛方式快速有效，不良反应少，能使活跃期明显加速，第二产程缩短；两组在产后出血、新生儿窒息、胎儿窘迫等方面差异无显著性。结论此镇痛方式快速有效，不良反应少，能使活跃期明显加速，缩短第二产程，降低剖宫产率，对母婴无不良影响，值得推广。

Influences of combined spinal- epidural block for analgesia during delivery

Objective To study the influences of combined spinal - epidural block for labor analgesia on both mothers and newborns. Methods 200 healthy nulliparous parturients without any obstetric compliations and anesthesia contraindieations were as study group,in which 120 cases have spontaneous labors. And the others have oxytoun activated labor. Another 200 nulliparous parturients without CSEB were randomly selected as controis. The influences of CSEB on the pain relief duration of labor delivery mode, postpartum hemorrhage, fetal distress, neonatal asphyxia and its side effect were observed and compared with control group. Results No side effect was observed in study group, study group have shorter active stage and second labor stage. There were no differences in postpartum hemorrhage, Neonatal asphyxia, fetal distress between two groups. Conclusion The analgesia delivery with CSEB is recommended for it is safe and highly effective in accelerating labor course,lowering cesarean section rate,without any side effect on motheres and fetuses.