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目的探讨小剂量布比卡因、芬太尼复合低浓度罗哌卡因联合麻醉用于分娩镇痛的效果及对母婴的影响。方法60例初产妇被随机分为两组,试验组(n=30)施行蛛网膜下腔+硬膜外阻滞(联合麻醉),向蛛网膜下腔注入布比卡因2mg+芬太尼0.05mg,其后以0.1%罗哌卡因行硬膜外阻滞,而对照组(n=30)没有采取分娩镇痛。观察镇痛效果、运动神经阻滞、产程进展、产程中胎心率变化、产后出血及分娩方式、新生儿Apgar评分情况。结果试验组分娩镇痛效果确切,与对照组比较,产妇的活跃期时间明显缩短,剖宫产率明显降低;第二产程、第三产程、产后出血量、产程中胎心率变化及新生儿Apgar评分,两组间差异无显著性(P>0.05)。结论小剂量布比卡因、芬太尼复合低浓度罗哌卡因联合麻醉用于分娩镇痛安全、快速、有效。
Objective To investigate the effect of low-dose bupivacaine and fentanyl combined with low-concentration ropivacaine anesthesia on labor analgesia and its effects on maternal and infant. Methods Sixty primipara were randomly divided into two groups. Subarachnoid + epidural block (combined anesthesia) was administered to the experimental group (n = 30), bupivacaine 2mg + fentanyl 0.05 mg followed by epidural block with 0.1% ropivacaine, whereas no analgesia was given in the control group (n = 30). Observe the analgesic effect, motor block, labor progress, changes in fetal heart rate during labor, postpartum hemorrhage and delivery mode, neonatal Apgar score. Results The analgesic effect of labor in experimental group was exact. Compared with the control group, the active period of maternal was shortened significantly and the rate of cesarean section was significantly decreased. The changes of second and third stage of labor, postpartum hemorrhage, fetal heart rate in labor and newborn Apgar score, no significant difference between the two groups (P> 0.05). Conclusion Combined low-dose bupivacaine and fentanyl combined with low-concentration ropivacaine anesthesia for labor analgesia is safe, rapid and effective.