硬膜外阻滞麻醉无痛分娩60例分析

目的:观察低浓度0.125%布比卡因与微量芬太尼联合用于硬膜外阻滞无痛分娩的疗效和对产程进展及母婴状况的影响。方法:采用镇痛药物为0.125%布比卡因加芬太尼(2mg/L),选择自愿要求分娩镇痛的单胎头位、无麻醉禁忌证的初产妇60例,宫口开大3～4cm时,行硬膜外麻醉分娩镇痛(观察组),并与同期条件相似、未给予任何镇痛方法的60例初产妇进行对照(对照组)了解观察组镇痛效果、不良反应,及对产程、分娩方式、产后出血、胎儿及新生儿的影响。结果:观察组镇痛有效率较对照组明显升高(P<0.01)。观察组活跃期较对照组缩短,宫颈扩张速度加快。两组分娩方式、产后出血、胎儿窘迫、新生儿窒息发生率比较,无显著性差异。结论:低浓度0.125%布比卡因加芬太尼(2mg/L)用于硬膜外无痛分娩,可达到分娩镇痛效果,加速产程,且对胎儿无不良影响,值得推广应用。

THE ANALYSIS OF 60 CASES OF PAINLESS LABOR BY EXTRADURAL BLOCK ANESTHESIA

Objective:To observe the curative effects of0.125%buprecaine with low dose fentanyl by extradural block for painless labor and the influences on the course and the conditions of both mothers and infants.Method:60cases of primipara,who voluntarily demanded painless birth with singleton infants in vertex presentations,no anesthetic contraindication,were chosen to use0.125%buprecaine20ml with40μg fentanyl when cervical dilation was to3～4cm by extradural block for painless birth(treat group).The other60cases of who had the similar conditions did not take any anesthesia(control group).The analgesia effects,side effects,the labor course,the delivery mode,the incidence of postpartum hemorrhage,fetal distress and neonatal asphyxia were all observed in the two groups.Results:The curative rate of treating group was significantly increased than that of the control group(P<0.01).The first stage of labor time was shorter and the speed of cervical dilatation accelerated in the treating group.There was no obvious differences in the birth mod,incidence of postpartum hemorrhage,fetal distress and neonatal asphyxia between two groups.Conclusion:0.125%buprecaine with40μg fentanyl by extradural block for painless labor has the advantages of analgesia,accelerating labor course,no harmful influences on the infants.It is a recommendable method.