罗哌卡因联合芬太尼用于蛛网膜下腔-硬膜外分娩镇痛55例

目的 ：探讨罗哌卡因联合芬太尼用于蛛网膜下腔-硬膜外联合阻滞麻醉在分娩过程的镇痛效果及安全性。方法：随机选取55例自愿要求无痛分娩的产妇，实施蛛网膜下腔-硬膜外联合阻滞麻醉，采用0.2%罗哌卡因联合芬太尼，并与同期55例未实施麻醉的产妇进行比较，观察两组的生命体征、镇痛评分、下肢运动评分、分娩方式、胎儿宫内窘迫发生率、新生儿Apgar评分、产后出血量及并发症等。结果：两组产妇生命体征稳定，镇痛组取得良好的镇痛效果，与对照组相比，胎儿宫内窘迫发生率显著降低（P <0.05），但是第一产程延长，产后2小时出血量增多（P <0.05）；分娩方式、新生儿Apgar评分及并发症两组无显著性差异。结论：蛛网膜下腔-硬膜外联合阻滞麻醉镇痛效果好，对产科质量无影响。

Clinical analysis on 55 cases of ropivacine combined with fentangl during subarachnoid and epidural anesthesia for labor

【Abstract 】: Objective:To investigate the pain relief effect and safety of ropivacine combined with fentangl during subarachnoid and epidural anesthesia for labor. Methods: 55 cases of pregnant woman volunteers were randomizedly administered combined subarachnoid and epidural anesthesia with 0.2% ropivacaine and fentangl, compared with another 55 control pregnant women who did not receive the combined anesthesia. The vital signs, score of analgesia, motor ability of lower extremities, birth process, the incidence of fetal distress, the manner of delivery, the neonatal Apgar’s score, the volumes of postpartum hemorrhage and complication were observed. Results: The vital signs in tow groups were stable. Good effect of analgesia was obtained in the anesthesia group. When compared with the control group, the incidence of fetal distress was decreased significantly (P <0.05), but the volumes of postpartum hemorrhage were increased and the first birth process was prolonged significantly (P<0.05). There was no difference in the manner of delivery, the neonatal Apgar’s score and complication between tow groups. Conclusion: Combined subarachnoid and epidural anesthesia can produce good effect of analgesia and has no effect on obstetric quality.