腰麻-硬膜外联合麻醉用于分娩潜伏期延长产妇镇痛的临床研究

目的探讨腰麻-硬膜外联合麻醉用于分娩潜伏期延长产妇的效果。方法选择100例潜伏期延长产妇,要求施行分娩镇痛的足月初产妇且潜伏期延长为观察组,不给分娩镇痛为对照组。观察组给予2 m L麻醉药(罗哌卡因2 mg和芬太尼10μg)注入蛛网膜下隙,60 min后连接PCA泵,胎儿娩出后停止硬膜外腔给药;对照组按产科常规处理。比较2组产程时间、分娩方式、催产素的使用情况及新生儿Apgar评分。结果观察组镇痛效果良好,第二产程时间显著长于对照组(P0.01)。观察组的第一产程时间短于对照组,剖宫产率低于对照组。2组的第三产程时间及新生儿Apgar评分无显著差异。结论腰麻-硬膜外联合麻醉用于分娩潜伏期延长产妇镇痛效果确切,能够缩短第一产程时间,对降低潜伏期延长产妇的剖宫产率有一定效果,对产妇及新生儿无不良影响。

Clinical research of lumbar and epidural anesthesia on analgesia efficacy in puerperae with prolonged incubation delivery

Objective To explore effect of the lumbar and epidural anesthesia for puerperae with prolonged incubation delivery.Methods A total of 100 puerperae with prolonged incubation delivery were selected, the full-term primiparae with analgesia were as observation group, and primiparae without analgesia were as control group.Observation group was given 2 mL anesthetics(ropivacaine for 2 mg and fentanyl for 10 μg) injected in the subarachnoid gap, and PCA pump was connected after 60 min.After the fetus was delivered, the epidural cavity administration was stopped.The control group implemented routine processing.Labor time, delivery methods, use condition of oxytocin, and neonatal Apgar score were observed.Results The observation group had better analgesic efficacy, and longer second stage of labor than the control group(P<0.01).Observation group had shorter first stage of labor and lower cesarean section rate than the control group.There was no significant difference in third stage of labor and neonatal Apgar scores.Conclusion Lumbar and epidural anesthesia with significant efficacy can shorten the first stage of labor, reduce cesarean section rate and adverse reactions of puerperae and newborns.