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目的研究对于产妇自控硬膜外分娩镇痛时,应用低浓度罗哌卡因复合舒芬太尼的临床效果以及相关不良反应。方法选择2 0 09年8月~2011年8月间我院诊治的240例初产妇,随机分为两组,对照组1 20例根据产科常规方法进行处理,不应用任何具有镇痛效果的药物;观察组12 0例给予0.5m g/L舒芬太尼和0.08%盐酸罗哌卡因混合液进行分娩镇痛,当V A S不低于3分时应用自控P C A泵维持镇痛;对两组产妇的产程进展、宫口开放程度、缩宫药物的使用情况进行详细记录,同时评价产妇精神状态及不良反应,镇痛期间评估运动神经阻滞程度,产程中出血量,记录胎头吸引助产以及行剖宫产手术等情况,对新生儿进行A pgar评分。结果比较两组产妇的H R、B P、SpO2及E C G等指标。观察组产妇3个产程V A S评分与对照组相比,差异有统计学意义(P<0.05)。两组产妇3个产程时间、B rom age法评估运动神经阻滞以及产程中出血量指标,差异无统计学意义(P>0.05),观察组产妇实施剖宫产率明显比对照组低,两组差异有统计学意义(P<0.05)。两组新生儿出生1 m in和5 m in的A pgar评分,差异无统计学意义(P>0.05)。结论当产妇实施自控硬膜外分娩镇痛时,应用低浓度罗哌卡因复合舒芬太尼的临床效果显著,对产妇的产程及新生儿无明显影响,产妇出现的不良反应小,安全有效。
Objective To study the clinical effects and the related adverse reactions of low concentrations of ropivacaine combined with sufentanil for maternal-controlled epidural analgesia. Methods Two hundred and forty cases of primipara in our hospital from August 2009 to August 2011 were randomly divided into two groups. One hundred and twenty cases in the control group were treated according to obstetrical methods, and no analgesic drugs ; Observation group 120 patients given 0.5mg / L sufentanil and 0.08% ropivacaine hydrochloride mixture for analgesia during labor, when the VAS is not less than 3 minutes, the use of controlled PCA pump to maintain analgesia; the two groups of mothers The progress of labor progress, the degree of openness of cervix and the use of shrinkage medicine were recorded in detail. Meanwhile, the mental status and adverse reactions of maternal women were evaluated. The extent of motor block, labor bleeding during labor, and fetal suction midwifery were recorded during analgesia Cesarean section line surgery and other conditions, neonatal A pgar score. Results The indexes of H R, B P, SpO 2 and E C G of the two groups were compared. Compared with the control group, the VAS score of 3 labor courses in the observation group was statistically significant (P <0.05). There was no significant difference in the indexes of motor block and labor bleeding between the two groups (P> 0.05). The rate of cesarean section in the observation group was significantly lower than that of the control group The difference was statistically significant (P <0.05). There was no significant difference in A pgar score between two newborns at 1 m in and 5 m in birth (P> 0.05). Conclusions When maternal implementation of controlled epidural analgesia, the application of low concentration of ropivacaine combined with sufentanil has a significant clinical effect, which has no significant effect on the labor process and newborn infants, and the maternal adverse reaction is small and safe and effective .