腰麻复合硬膜外阻滞行分娩镇痛效果的临床观察  

Clinical Observation on Delivery Pain Assuagement Via Combined Lumbar & Epidural Anesthesia

作　　者：马晓慧[1] 胡宏东 刘继云[2] 

机构地区：[1]广州市花都区妇幼保健院,广州510800 [2]广州市第一人民医院,广州510182

出　　处：《宁夏医学院学报》2006年第4期301-303,共3页Journal of Ningxia Medical College

摘　　要：目的探讨腰麻复合硬膜外阻滞(CSEA)行分娩的镇痛效果及安全性。方法选择行分娩镇痛(镇痛组)和自然分娩(对照组)的足月初产妇(ASAI^II级)各50例。镇痛组在蛛网膜下腔注入芬太尼2μg,硬膜外腔置管,接自控镇痛泵,30min后硬膜外给予0.1%罗哌卡因和2μg/mL芬太尼混合液行硬膜外自控镇痛(PCEA)。持续量5mL/h,自控量每次3mL,锁定时间为10min。比较镇痛前后产妇血压、心率、呼吸频率、脉搏血氧饱和度、宫缩程度及双下肢运动神经阻滞程度;观察两组镇痛效果、产程时间、产后出血量、分娩方式、镇痛对胎儿及新生儿的影响。结果镇痛组行PCEA前后的血压、脉搏、呼吸、血氧饱和度、宫缩强度及双下肢活动程度比较均无统计学意义(P>0.05)。镇痛组与对照组镇痛评级比较有显著差别(P<0.01);镇痛组活跃期较对照组显著缩短(P<0.01);镇痛组第二、三产程、产后出血量、分娩方式、新生儿Apgar评分与对照组比较差异无统计学意义(P>0.05)。结论腰麻复合硬膜外阻滞行分娩镇痛效果满意,母婴安全,是分娩镇痛较理想的方法。Objective To probe into the effectiveness and safety of delivery pain assuagement via combined lumbar ＆ epidural anesthesia. Method Two groups with 100 case were recruited. 50 for the natural delivery group, and another 50 （pain assuagement group） undergone injection of Fentanyl to the subarachnoid space together with epidural intubation linked to self-control pain assuagement pump filled with 0.1% Ropivacaine ＆ 2μg/mL Fentanyl for PECA with the sequence of durative dosage 5mL/h, self-control dosage 3mL and fixed time 10 min. Observation and comparison were proceeded to realize the BP, HR,RR, blood oxygen saturation, uterine contraction and extent of motor nerve block retardance of two limbs in each group, and meanwhile the effectiveness of pain assuagement, labor duration time, post-partum bleeding, way of delivery, influences of pain assuagement on fetus and neonate between the two groups. Results No statistical differences were found between the two groups in age, body height, body weight, pregnance duration and extent of os uterus enlargement（ P 〉 0.05）, and 1st ＆ 2nd labor duration, post-partum bleeding, way of delivery and Apgar rating for neonate（ P〉 0.05）. No statistical differences were found as well in BP, HR, RR, blood oxygen saturation, uterine contraction and extent of motor nerve block retardance of two limbs for pain assuagement group（ P 〉 0.05） but there is significantly statistical differences between the two groups （ P 〈 0.01 ）. Active phase was shorted in the pain assuagement group compared with the natural delivery group（ P 〈 0.01 ）. Conclusion The effectiveness and safety for both mother and child of delivery pain assuagement via combined lumbar ＆ epidural anesthesia are satisfied. it would undoubtedly to be one of the best methods for delivery pain assuagement.

关 键 词：腰麻 硬膜外阻滞 分娩镇痛 

分 类 号：R714.3[医药卫生—妇产科学]