芬太尼用于产妇阴道分娩后的镇痛效果  

Analgesic effect of fentanyl on puerpera after parturition

作　　者：孟岚[1] 时飞[1] 王洵 

机构地区：[1]青岛市立医院麻醉科,266011 [2]青岛市立医院产科,266011

出　　处：《实用疼痛学杂志》2012年第2期121-123,共3页Pain Clinic Journal

摘　　要：目的 探讨产妇在胎儿娩出后静脉注射芬太尼的镇痛效果。方法 选择经阴道分娩有意外会阴裂伤、胎盘残留的产妇100例，随机分为A、B两组，每组50例。于胎儿娩出即刻，A组静脉注射芬太尼1．5～2．0ug／kg，B组静脉注射等容量的生理盐水。比较两组产妇给药后的呼吸循环变化及视觉模拟评分（VAS），观察两组产妇会阴修补时间、胎盘清除的难易程度、产妇催乳素分泌及泌乳的情况。结果A组胎盘较易清除，MAP、HR、RR、VAS评分、会阴修补时间及乳汁分泌不足的发生率均低于B组，差异有统计学意义（P〈0.05或P〈0.01），哺乳次数A组多于B组（P〈0.05），SpO2两组差异无统计学意义。结论在胎儿娩出后，遇到会阴意外裂伤、胎盘植入、胎盘残留急需镇痛才能使产妇配合手术操作的情况下，静脉注射芬太尼是安全可靠，简单有效的镇痛方法。Objective To explore the analgesic effect of intravenous fentanyl on puerpera after parturition. Methods One hundred puerperas via vaginal delivery, encountered an unexpected peri- neal laceration or retained placenta, were divided into two groups, groupA and B. Puerperas were in- travenously received fentanyl 1.5 -2.0 ug/kg in group A and the same volume of normal saline in group B. MAP, HR, RR, SpO2, VAS, and the time of perineum repaired, the clearance of placenta, the prolactin secretion and lactation were observed after the injection. Results It was much easier to clear the placenta out, and needed shorter time to repaired the perineum in group A than those in group B. MAP, HR, RR and VAS and the incidence rate of insufficient lactation was lower in group A than those in group B. While the times of nursing was much higher in group A than that in group B（P〈0.05）. There was no significant difference in SpO2. Conclusion It is an effective and reliable method to relieve pain by fentanyl injected intravenously, undergoing the emergent conditions of peri- neal laceration or retained placenta after parturition.

关 键 词：芬太尼 镇痛 分娩 

分 类 号：R473.71[医药卫生—护理学]