罗哌卡因配伍芬太尼分娩镇痛对持续性枕后位分娩方式的影响

目的了解罗哌卡因配伍芬太尼用于分娩镇痛对持续性枕后位产程的影响。方法回顾性分析2006年1月—2007年12月在南方医科大学华瑞医院分娩的产妇,有适应症无禁总症而自愿接受分娩镇痛的46例持续性枕后位产妇为镇痛组,条件相似未行镇痛的63例持续性枕后位产妇为对照组,记录两组头盆评分、活跃期时间、各产程时间、分娩方式、产程中处理方式、产后出血、软产道裂伤、各组中发生新生儿窒息的例数。结果第一产程、第二产程和总产程时间、阴道手术助产、新生儿窒息率两组间无差别。镇痛组第二产程延长、阴道顺产率高于对照组,活跃期更快、徒手旋转胎头成功率高。结论罗哌卡因配伍芬太尼镇痛分娩可提高持续性枕后位徒手旋转胎头的成功率,提高顺产率,不增加阴道手术助产和新生儿窒息率。

The influence of epidural ropivacaine in combination with fentanyl in delivery of occiput posterior position

Objective To investigate the influence of epidural ropivacaine in combination with fentanyl in delivery of occiput posterior position. Methods 46 healthy primigravidas in spontaneous labour who requested epidural analgesia from January in 2006 to December in 2007 were enrolled as experimental group, 63 primigravidas with the same condition who refused epidural analgesia were enrolled as control group. Recorded delivery score of apholic position, active stage and every birth process time, delivery modality, management of birth process, amount of postpartum hemorrhage, laceration of birth canal, and asphyxia neonatorum. Results There were no differences in the first, the third and total birth process, ratio of operation labor by vagina and asphyxia neonatorum. The second birth process was prolonged in experimental group. The ratio of spontaneous labor and revolving fetal head by hand were raised in experimental group, whereas active stage was shortened. Conlusion Epidural ropivacaine in combination with fentanyl in labour can increase the ratio of revolving fetal head by hand and delivery. The ratio of asphyxia neonatorum and operation labor by vagina were not raised.