摘要
目的探讨罗哌卡因用于分娩镇痛对产妇产程和分娩方式的影响。方法采用回顾性分析的方法,选择行0.1%罗哌卡因+芬太尼(1μg/ml)硬膜外阻滞的190例健康、单胎、足月临产初产妇为镇痛组。另选择同期222例条件相似、未行任何镇痛措施的自然临产产妇为对照组。记录两组产妇产程时间、分娩方式、新生儿1分钟和5分钟Apgar评分。结果(1)产程时间比较:镇痛组第一产程、第二产程和总产程时间分别为(426±161)min、(54±27)min、(489±166)min;对照组分别为(364±167)min、(37±22)min、(409±170)min,两组比较,差异均有统计学意义(P<0.01)。(2)分娩方式比较:镇痛组阴道器械助产率为20.0%(38/190),明显高于对照组的6.3%(14/222),两组比较,差异均有统计学意义(P<0.01);镇痛组剖宫产率及阴道顺产率分别为20.0%(38/190)、60.5%(115/190),对照组分别为28.4%(63/222)、65.8%(146/222),两组比较,差异均无统计学意义(P>0.05)。(3)Apgar评分比较:镇痛组新生儿1分钟及5分钟Apgar评分<7分者分别为7.9%(15/190)、2.6%(5/190),对照组分别为4.5%(10/222)、0.5%(1/222),两组比较,差异均无统计学意义(P>0.05)。结论罗哌卡因用于分娩镇痛对产妇产程有延长作用及增加阴道器械助产率,但对新生儿出生结局无明显影响。
Objective To study the effects of ropivacaine on the duration of labor and mode of delivery in the primigravidas using patient-controlled epidural analgesia (PCEA). Methods Retrospective analysis was performed. The 190 healthy, full-term, and single-fetus parturient primigravidas who received PCEA with 0.1% ropivacaine+fentanyl (1 μg/ml ) were in the epidural analgesia group. Another 222 primigravidas who didnot receive PCEA were in the control group. The duration of labor and modes of delivery, and the neonatal Apgar scores in both two groups were recorded and evaluated. Results Those in the epidural analgesia group experienced a significantly longer first stage [(426±161) minutes], longer second stage [(54±27) minutes] and longer full duration of delivery [(489±166) minutes] than those in the control one [(409±170) minutes, (364±167) minutes and (37±22) minutes]. The rate of using pitocin in the epidural analgesia group (30.2 %) was significantly higher than that in the control group (4.1%). The cesarean section rate in epidural analgesia group (20.0 %) was lower than that in the control one (28.4%); while the rate of instrumental delivery in the epidural analgesia group (20.0%) was significantly higher than that in the control one (6.3%). In summary, there were significant differences between two groups in the duration of labor, the rate of using pitocin, the rate of instrumental delivery and the rate of cesarean section. But there were no differences found for those newborn who had Apgar scores less than 7 at the point of both one and five minutes (7.9% and 4.5%, 2.6% and 0.5% respectively). Conclusion Epidural ropivacaine labor analgesia lengthens the duration of labor and increases the rate of instrumental delivery, but it has no significant negative effects on the neonates.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2005年第6期369-371,共3页
Chinese Journal of Obstetrics and Gynecology
