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目的探讨低浓度罗哌卡因联合芬太尼进行腰麻—硬膜外联合阻滞(CSEA)用于分娩镇痛的临床效果。方法选择自愿接受分娩镇痛、无产科及CSEA麻醉禁忌证、ASAⅠ～Ⅱ级的产妇100例为观察组,另选择同期未采取任何分娩镇痛药物而进入产程的产妇100例为对照组。观察组在产妇宫口开至3cm时,行蛛网膜下腔穿刺注入布比卡因1.5mg后,并以0.1%罗哌卡因和2μg/kg芬太尼的混合液输注,速率6ml/h;对照组未进行分娩镇痛。比较2组产程、分娩方式及新生儿Apgar评分。结果观察组产痛明显减轻,与对照组比较差异有统计学意义(P<0.01)。2组产程、分娩方式及新生儿Apgar评分比较差异无统计学意义(P>0.05)。结论低浓度罗哌卡因联合芬太尼进行CSEA是一种安全有效的分娩镇痛方法。
Objective To investigate the clinical effect of low concentration ropivacaine combined with fentanyl for spinal anesthesia and epidural blockade (CSEA) for labor analgesia. Methods 100 cases of ASA Ⅰ ~ Ⅱ maternal were selected as the observation group, and 100 maternal women who did not take any labor analgesia during the same period were selected as the control group. Observation group in the maternal uterine opening to 3cm, subarachnoid puncture injection of bupivacaine 1.5mg, and a mixture of 0.1% ropivacaine and 2μg / kg fentanyl infusion rate of 6ml / h; control group did not labor analgesia. The two groups of labor, delivery mode and neonatal Apgar score were compared. Results The observation group pain relief significantly reduced compared with the control group was statistically significant (P <0.01). There was no significant difference between the two groups in terms of labor, delivery mode and neonatal Apgar score (P> 0.05). Conclusion Low concentration of ropivacaine combined with fentanyl for CSEA is a safe and effective method of labor analgesia.