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目的 研究低浓度罗哌卡因硬膜外分娩镇痛的效果及其对产程的影响。方法 选择 6 0例足月初产妇 ,ASA为 1～ 2级 ,单胎头位 ,随机分硬膜外分娩镇痛 30例作为观察组 ,自然分娩 30例作为对照组。观察组产妇宫口开 2～ 3cm时 ,L2～ 3 硬膜外注入 0 15 %罗哌卡因 +0 0 0 0 2 %芬太尼 ,首剂 6～ 8ml,维持 6～ 8ml/h。观察比较两组的产痛程度 (VAS评分 )、产程时间、宫缩强度和频率、分娩方式、新生儿Apgar评分。 结果 观察组产妇用药后 10～ 15min均感产痛明显减轻或无痛 ,疼痛视觉模拟评分 (VAS)明显低于对照组 (P<0 0 1)。观察组镇痛初期宫缩强度下降、频率减慢 ,随产程进展逐渐恢复并增强。两组的活跃期时间、第二产程时间、分娩方式、新生儿Apgar评分差异均无显著意义 (P >0 0 5 )。 结论 低浓度罗哌卡因硬膜外分娩镇痛效果确切 ,不影响产程进展 ,对母婴安全。
Objective To study the effect of epidural analgesia with low concentration of ropivacaine on labor process. Methods Sixty cases of full-term primiparous women with ASA grade 1 to 2 and single head position were randomly divided into observation group (n = 30) and spontaneous childbirth (n = 30) as control group. Observation group maternal uterine opening 2 ~ 3cm, L2 ~ 3 epidural 0% 15% ropivacaine +2002 fentanyl, the first dose of 6 ~ 8ml, maintaining 6 ~ 8ml / h. Observe the pain intensity (VAS score), labor time, uterine contractions intensity and frequency, mode of delivery, Apgar score of neonates in two groups. Results In the observation group, the pain-relieving pain rate was significantly reduced or painless at 10 to 15 minutes after treatment, and the pain visual analogue scale (VAS) was significantly lower than that of the control group (P <0.01). In the observation group, the contractile strength and the frequency of contractions decreased at the initial stage of pain relief, and gradually recovered and enhanced with the progress of labor. There were no significant differences between the two groups in the active period, the second stage of labor time, mode of delivery, and neonatal Apgar score (P> 0.05). Conclusions The epidural analgesia with low concentration of ropivacaine is exact and does not affect the progress of labor and the safety of mother and infant.