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目的:回顾分析低浓度罗哌卡因复合舒芬太尼硬膜外自控镇痛在不同时机用于分娩镇痛的效果及对产妇选择分娩方式的影响。方法:将嘉兴市妇幼保健院2005年1月-2011年12月间临产后实施硬膜外分娩镇痛的产妇11 250例,按镇痛实施时间不同分为2组:Ⅰ组宫口开至1～3cm(n=8 270),Ⅱ组宫口开至3cm以上(n=2 980)。分别观察产程时间、手术助产率、新生儿体重和Apgar评分情况,产后24小时随访。结果:各组镇痛效果确切,产程时间、新生儿体重和Apgar评分组间差异无统计学意义(P>0.05);产妇对镇痛效果满意,硬膜外镇痛对自然分娩有帮助。结论:低浓度罗哌卡因复合舒芬太尼硬膜外自控镇痛用于分娩镇痛安全、有效,可以在第一产程早期施行,能促进产妇选择自然分娩,从而降低剖宫产率。
OBJECTIVE: To retrospectively analyze the effect of epidural analgesia with low concentration of ropivacaine combined with sufentanil on labor analgesia at different times and on the choice of delivery mode. Methods: 11 250 cases of epidural analgesia after labor in Jiaxing Maternal and Child Health Hospital from January 2005 to December 2011 were divided into 2 groups according to the different time of analgesia. Group Ⅰ: 1 ~ 3cm (n = 8 270), group Ⅱ cervix to more than 3cm (n = 2 980). The duration of labor, surgical midwifery, neonatal weight and Apgar score were observed, followed up 24 hours postpartum. Results: The analgesic effect of each group was exact, and there was no significant difference in labor time, neonatal weight and Apgar score between the two groups (P> 0.05). Maternal satisfaction was satisfactory and epidural analgesia was helpful for spontaneous labor. CONCLUSIONS: Low-dose ropivacaine combined with sufentanil and epidural analgesia is safe and effective for labor analgesia. It can be administered early in the first stage of labor and can promote mothers to choose natural childbirth and thus reduce cesarean section rate.