硬膜外分娩镇痛对脐血血气分析的影响

目的:观察硬膜外分娩镇痛时对胎儿血气分析结果及产程、母婴的影响。方法:240例产妇随机分为镇痛组和对照组:镇痛组120例,采用0.125%布比卡因,负荷量8~10 mL,持续量4 mL/h,产妇自控硬膜外镇痛(PCEA);对照组120例,自然分娩者。比较两组产妇脐动、静脉血气分析、SBP、DBP、HR、SPO2、总产程(第1、第2产程时间)、新生儿Apgar评分、视觉模拟评分(VAS)。结果:①两组新生儿脐血血气分析指标测定值均在正常范围,总产程比较,差异无统计学意义;②两组新生儿出生后5 min Ap-gar评分均为8分以上;③镇痛药起效后产妇疼痛明显减轻,宫缩时仅感腹部发紧、发胀,双下肢无麻木感,活动自如。两组产妇VAS在镇痛前、后差异有统计学意义(P<0.05)。结论:0.125%布比卡因用于镇痛效果可靠,不延长产程,对新生儿无不良影响。

The influences of epidural delivery analgesia on umbilical cord blood gas analysis

Objective:To observe the influences of epidural delivery analgesia during labor on fetal blood gas analysis and the birth process.Methods:240 cases of lying-in women were divided randomly into maternal analgesia group(n=120)and the control group(n=120).The analgesia group used 0.125% bupivacaine,load 8-10 ml,sustained in 4 ml / h, maternal-controlled epidural analgesia(PCEA).The control group was natural childbirth.The umbilical artery and venous blood gas analyses,SBP,DBP,HR,SPO2,the birth process,neonatal Apgar score and visual analog score(VAS) were determined and compared between two groups.Results:①The indices of neonatal cord blood gas analysis were in the normal range for both groups.The comparison of middle birth process showed not significant difference.②Apgar scores were more than eight points at 5 min after birth for both groups.③ The analgesics significantly reduced pain when it worked,the only sense was the abdominal tight expansion and no lower limbs numbness when uterine contraction. VAS index showed a significant difference(P<0.05) before and after analgesia.Conclusion:0.125% bupivacaine has reliable analgesic effect and no lasting birth process and no adverse effects on newborns.