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目的：比较硬膜外不同芬太尼给药模式用于活跃期分娩镇痛的麻醉效果及安全性。方法选择初产妇60例，随机均分为 A、B 两组，另选无镇痛产妇30例作对照组（C 组）。产妇宫口开至3 cm 时，行硬膜外分娩镇痛。两组首剂均采用0.1%盐酸罗哌卡因+2μg/ ml 芬太尼，维持配方 A 组为0.1%盐酸罗哌卡因+1μg/ ml 芬太尼，B 组为0.1%盐酸罗哌卡因，背景持续剂量6 ml/ h，自控剂量4 ml/20 min，镇痛分娩过程中如镇痛不足，单次追加芬太尼10μg。观察各组镇痛效果，运动神经阻滞程度及恶心呕吐、皮肤瘙痒、尿潴留等不良反应发生情况；记录新生儿 Apgar 评分情况，芬太尼使用量等指标。结果 A 组和 B 组镇痛效果、运动神经阻滞程度差异无统计学意义，A 组芬太尼使用量（36.8±16.2μg）显著多于 B 组（21.1±3.2μg）（ P <0.01）。A、B 两组 VAS 评分显著低于 C 组（ P <0.01）。结论0.1%罗哌卡因用于活跃期硬膜外分娩镇痛，首剂复合2μg/ ml 芬太尼，镇痛效果良好，维持期复合芬太尼与否，镇痛效果相似。“,”Objective To compare the effect and safety of epidural labor analgesia in actived phase by different dosage regimens of Fenta-nyl. Methods 60 primigravidas were randomly divided into two groups,group A and group B. In addition 30 primigravidas with no analgesia were considered as a control group. At the time of cervical dilatation to 3 cm,epidural block was used for labor analgesia. 0. 1% Ropivacaine plus 2 μg/ ml Fentanyl were used in both group A and group B for initial dose. 0. 1% Ropivacaine plus 2 μg/ ml Fentanyl was considered as continues recipe for group A,while 0. 1% Ropivacaine only for group B. Background infusion was 6 ml/ h,patient - controlled epidural dose was 4 ml/ 20 min. If the primigravida felt sore during the labor obstetric,infused 10 μg Fentanyl only. The analgesic effect,degree of motor block,nausea and vomiting,itch of skin,retention of urine,the Apgar score,the Fentanyl dose were recorded respectively. Results Compared group A and group B,there were no difference in analgesic effect and degree of motor block. The dose of Fentanyl used in group A(36. 8 ± 16. 2 μg)was especially higher than group B(21. 1 ± 3. 2 μg)( P < 0. 01). The VAS scores of group C were especially higher than those in group A and group B( P <0. 01). Conclusion 0. 1% Ropivacaine combined with 2 μg/ ml Fentanyl used for initial dose can provide satisfactory analgesia for epidural labor analgesia in actived phase,and there are nearly the same analgesic effects either Fentanyl is used for continues recipe or not.