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目的 探讨雷米芬太尼静脉自控镇痛(PCIA)用于产科分娩镇痛的临床有效性和安全性.方法 60例健康初产妇随机分为雷米芬太尼PCIA镇痛组(Ⅰ组)和未予镇痛对照组(Ⅱ组),每组30例.观察分娩VAS评分、镇静评分、术后满意度评分及各产程时间、分娩方式、催产素使用及第一产程活跃期时间和官口扩张进程.并记录新生儿出生后1、5 min Apgar评分、胎心率(FHR)及不良反应.结果 与镇痛前和Ⅱ组相比,Ⅰ组镇痛后15 min、1 h、宫口开全和胎儿娩出时VAS评分降低、镇静评分升高(P<0.05).与Ⅱ组相比,Ⅰ组产后24 h满意度评分较高(P<0.05).两组FHR和新生儿出生后1、5 min Apgar评分均在正常范围.Ⅰ组产妇镇痛期眩晕发生率高于Ⅱ组(P<0.05).结论 雷米芬太尼PCIA用于分娩镇痛有效且无明显不良反应.“,”Objective To study the efficacy and safety of patient-controlled intravoenus analgesia(PCIA)with remifentanil for labour. Methods Sixty healthy term primiparas were randomly assigned to two groups with 30 eases each. The parturients in group Ⅰ received PCIA with remifentanil (continuous background infusion of 0.05μg·kg~(-1)·min~(-1) and 0.25 g/kg bolus dose with 2 min lockout period) and those in group Ⅱ were given no analgesia as the controls.The intensity of pain was evaluated by VAS. The labour process, mode of delivery, requirement of oxytocin, sarisfaction and sedation scores, fetal heart rate(FHR),Apgar score of neonates and side effects were recorded. Results Compaered with before and group Ⅱ,the VAS was lower and the satisfaction score, sedation scores were higher in group Ⅰ.Incidence rate of dizziness Was higher in group Ⅰ than that in group Ⅱ.FHR and the 1- and 5-min Apgar scores of neonates were within uorrflal limits in both groups.Conclusion PCIA with remifentanil for labour is effective without significant side effects.