雷米芬太尼静脉分娩镇痛效果及其对新生儿的影响  

Efficacy of intravenous remifentanil analgesia for labour and its influence on neonates

作　　者：姚飞[1] 许少军[1] 沈明坤[1] 

机构地区：[1]南京医科大学附属无锡妇幼保健院麻醉科,江苏省214002

出　　处：《江苏医药》2014年第10期1159-1160,共2页Jiangsu Medical Journal

摘　　要：目的探讨雷米芬太尼静脉分娩镇痛效果及其对新生儿的影响。方法 100例自然分娩初产妇随机均分为观察组和对照组。观察组施行雷米芬太尼静脉镇痛,镇痛药:雷米芬太尼1mg用生理盐水稀释至50ml,负荷量为泵内溶液1ml,背景剂量5ml/h,PCA剂量1ml,锁定时间3min;持续至宫口开全。对照组不用分娩镇痛药物。比较两组产妇宫缩VAS疼痛评分,记录产妇满意度评分、新生儿Apgar评分和不良反应。胎儿娩出后取脐动脉血行血气分析。结果观察组VAS疼痛评分低于对照组[(1.35±0.88)分vs.(8.52±0.93)分](P<0.05);观察组满意度评分高于对照组[(8.92±0.65)分vs.(2.25±0.55)分](P<0.05)。两组均无发生心律失常、呼吸抑制、恶心呕吐、皮肤瘙痒及头晕、嗜睡等不良反应。两组新生儿1-min Apgar评分[(9.6±0.4)分vs.(9.5±0.5)分]和脐动脉血气分析指标相仿(P>0.05)。结论雷米芬太尼静脉分娩镇痛安全有效,不良反应少,对新生儿无不良影响。Objective To observe the efficacy of intravenous remifentanil analgesia for labour and its influence on neonatus. Methods A total of 100 parturients was randomly allocated to two groups. The patients in group A were given intravenous analgesia with remifentanil（remifentanil 1 mg in normal saline 50 ml） 1 ml in bolus and 5 ml/h as background infusion untill totally cervix opening. The PCA dose was 1 ml with lockout time of 3 rain. The patients in group B did not use analgesia as the controls. The efficacy of analgesia was evaluated with VAS. The delivery satisfaction score, Apgar score of the neonates and side effects were compared between two groups. The umbilical artery gas analysis was performed. Results The VAS score was significantly lower in group A than that in group B[（1.35±0. 88） points vs. （8.52±0. 93） points] （P〈0. 05）. The delivery satisfaction score was significantly higher in group A than that in group B[（8. 92±0.65） points vs. （2. 25 ±0. 55） points] （P〈0.05）. There were no significant differences in l-min Apgar score[（9.6 ± 0.4） points vs. （9.5±0. 5） points] （P〉0. 05）, umbilical artery gas analysis and side effects between two groups. Conclusion Remifentanil intravenous analgesia for labour is effective and safe without severe effects on neonates.

关 键 词：雷米芬太尼 分娩镇痛 

分 类 号：R614[医药卫生—麻醉学]