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目的探讨腰硬联合阻滞麻醉(CSEA)联合硬膜外自控镇痛(PCEA)下使用罗哌卡因复合舒芬太尼或芬太尼用于分娩镇痛效果。方法 62例实施分娩镇痛的足月产妇作为研究对象,根据随机数字表法分为观察组和对照组,各31例。观察组给予CSEA联合PCEA下使用罗哌卡因联合舒芬太尼,对照组给予CSEA联合PCEA下使用罗哌卡因复合芬太尼,比较各时间段的视觉模拟评分法(VAS)评分、运动阻滞情况、产程时间、分娩方式、新生儿Apgar评分及不良反应。结果观察组宫口开3、6、10 cm的VAS评分分别为(2.01±0.33)、(2.55±0.76)、(3.45±1.26)分,均低于对照组的(3.12±0.78)、(3.15±0.79)、(4.55±1.27)分,差异均有统计学意义(P<0.05)。两组运动阻滞情况比较差异无统计学意义(P>0.05);两组产程时间、分娩方式比较差异无统计学意义(P>0.05);两组新生儿Apgar评分及不良反应发生情况比较差异无统计学意义(P>0.05)。结论 CSEA联合PCEA下使用罗哌卡因复合舒芬太尼用于分娩镇痛效果好,对产妇和胎儿安全。
Objective To investigate the analgesic effect of ropivacaine combined with sufentanil or fentanyl for labor during the combined spinal epidural anesthesia (CSEA) and epidural analgesia (PCEA). Methods Sixty-two full-term pregnant women who were given labor analgesia were divided into observation group and control group according to the random number table method, with 31 cases in each group. The observation group was given ropivacaine combined with sufentanil under CSEA and PCEA. The control group was given ropivacaine combined with fentanyl under CSEA and PCEA. The visual analog scale (VAS) Blocking, labor time, mode of delivery, neonatal Apgar score and adverse reactions. Results The VAS scores of cervix 3,6,10 cm in the observation group were (2.01 ± 0.33), (2.55 ± 0.76) and (3.45 ± 1.26) points lower than those in the control group (3.12 ± 0.78, 3.15 ± 0.79), (4.55 ± 1.27), the difference was statistically significant (P <0.05). There was no significant difference between the two groups in motor block (P> 0.05). There was no significant difference in labor time and mode of delivery among the two groups (P> 0.05). Apgar score and adverse reactions in neonates in both groups were significantly different No statistical significance (P> 0.05). Conclusion CSEA combined with PCEA ropivacaine combined with sufentanil for labor analgesia is good, safe for the mothers and fetuses.