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目的 探讨布比卡因硬膜外自控镇痛和罗哌卡因蛛网膜下腔 -硬膜外自控镇痛用于分娩的效果及对产程、母婴的影响。方法 90例初产妇分为 3组 ,布比卡因硬膜外自控镇痛组 (A组 ,n =3 0 )、罗哌卡因蛛网膜下腔 -硬膜外自控镇痛组 (B组 ,n =3 0 )和对照组 (C组 ,n =3 0 ,未行分娩镇痛 ) ,观察各组镇痛效果、产程时间、分娩方式、血清皮质醇及新生儿Apgar评分情况。结果 A ,B组镇痛效果满意 ,以B组为佳 ;两组第一产程末血清皮质醇浓度明显低于C组 (P <0 0 1) ;镇痛组活跃期较C组缩短 (P <0 0 5 ) ;分娩方式及Apgar评分各组间无差异。结论 两种方法用于分娩镇痛效果满意 ,对产妇及新生儿无不利影响 ,罗哌卡因蛛网膜下腔 -硬膜外自控镇痛更具优势
Objective To investigate the effects of epidural bupivacaine-controlled analgesia and ropivacaine-induced subarachnoid-epidural analgesia on delivery and the effects of labor and maternal and infant. Methods Ninety primipara were divided into 3 groups: bupivacaine epidural analgesia group (group A, n = 30), ropivacaine subarachnoid - epidural analgesia group (group B) , n = 30) and control group (n = 30 in group C, n = 30). The analgesic effect, labor duration, mode of delivery, serum cortisol and neonatal Apgar score were observed. Results The analgesic effect was satisfactory in group A and group B, which was better in group B. The serum cortisol concentration at the end of the first stage of labor in both groups was significantly lower than that in group C (P <0.01); the activity of analgesic group was shorter than that in group C <0 0 5). There was no difference between the mode of delivery and Apgar score in each group. Conclusions Both methods are satisfactory for analgesia during labor and have no adverse effect on maternal and newborn babies. Ropivacaine - subarachnoid - epidural analgesia is more advantageous