腰麻及硬膜外麻醉联合应用于产科分娩镇痛的临床探讨  

Application of spinal and epidural anesthesia in labor analgesia

作　　者：周国伟 边丹秀 徐萌艳[3] 

机构地区：[1]诸暨市妇幼保健院麻醉科,浙江绍兴311800 [2]诸暨市妇幼保健院产科,浙江绍兴311800 [3]浙江大学医学院附属妇产科医院麻醉科,杭州310006

出　　处：《中国性科学》2016年第1期120-122,共3页Chinese Journal of Human Sexuality

基　　金：浙江省医药卫生一般研究计划项目(2011KYB046)

摘　　要：目的:观察腰-硬联合麻醉用于分娩镇痛的临床疗效。方法:选取在我院分娩的120例产妇作为研究对象,根据分娩镇痛方法的不同,将其分为研究组和对照组,各60例,对照组采用持续硬膜外麻醉,研究组采用腰-硬联合麻醉,比较两组的镇痛效果、分娩结局等。结果:两组的顺产率、镇痛效果比较无显著性差异(P>0.05);研究组的麻醉起效时间显著短于对照组,罗哌卡因总用量显著少于对照组,P<0.05。研究组的麻醉起效时间为(3.5±1.2)min,对照组为(15.1±5.5)min;研究组的罗哌卡因总用量为(9.7±4.1)mg,对照组为(20.1±7.5)mg。研究组的麻醉起效时间显著短于对照组,罗哌卡因总用量显著少于对照组,P<0.05,t值分别为15.96、9.42,差异均具有统计学意义(P<0.05)。结论:在产科分娩镇痛中采用腰-硬联合麻醉,具有起效迅速、镇痛效果好、麻药用量少等优点,能够有效减轻产妇分娩过程中的痛苦,值得推广应用。Objectives：To observe the curative effect of spinal and epidural anesthesia for labor analgesia.Methods：120 puerperae in our hospital were selected and according to the method of analgesia in labor,was divided into study group and control group,each of 60 cases.The control group used continuous epidural anesthesia,while the study group received combined spinal and epidural anesthesia.The analgesia effect and delivery outcome of the two groups was compared.Results：Difference in the rate of vaginal delivery and analgesic effect between the two groups was not significant（ P〈 0.05）.The onset time of anesthesia in study group was（ 3.5 ± 1.2） min,significantly shorter than the（ 15.1 ± 5.5） min in the control group.The total dosage of ropivacaine in the study group was（ 9.7 ± 4.1） mg,significantly less than the（ 20.1 ± 7.5） mg in the control group,P〈 0.05.The t values were15.96 and 9.42 respectively,with statistically significant difference.Conclusions：The combined spinal and epidural anesthesia in labor analgesia has the advantages of quick onset,good analgesic effect and less anesthetic dosage,which can effectively reduce the delivery pain and worthy of popularization and application.

关 键 词：分娩镇痛 硬膜外麻醉 腰麻 

分 类 号：R473.71[医药卫生—护理学]