【摘要】 目的:探讨小计量布比卡因伍用芬太尼硬膜外麻醉和笑气吸入用于分娩镇痛的临床效果及实用性与安全性。方法:随机将667例产妇分为3组。在分娩过程中,硬膜外麻醉组232例,采用硬膜外腔注入布比卡因和芬太尼混合液;笑气吸入组251例,吸入含有50%氧化亚氮和50%氧气的混和气体;对照组184例,未给予镇痛药物。观察3组的镇痛效果、产程时间、分娩方式、产后出血量、胎儿及新生儿情况。结果:镇痛效果比较,3组间0级镇痛相比差异有极显著性(P<0.01);镇痛起效时间和持续时间比较,硬膜外麻醉组长于笑气吸入组(P<0.01);产程时间比较,镇痛组第一产程时间短于对照组(P<0.05);分娩方式比较,硬膜外麻醉组阴道助产率为9.1%,高于另两组(P<0.01);进入活跃期末及第二产程催产素使用和并发症发生情况比较,镇痛组高于对照组(P<0.01)。结论:硬膜外麻醉用于分娩镇痛效果确切,镇痛完全,对产妇及新生儿无明显副作用,可用于正常及妊娠期高血压疾病的产妇;笑气吸入用于分娩镇痛有较好的镇痛效果,方便简单,对母儿无明显的副作用,值得在基层推广使用。更多还原

【Abstract】 Objective:To investigate the clinical efficacy and safety of the small dose bupivacaine and fentanyl were injected in thy epidural space and labor analgesia with inhalation of nitrous oxide.Methods:The 667cases of pregnant women were randomly divided into 3 group,Epiclural analgesic group(n=232)fentanyl and bupivacaine were injected in the epiclural space cluring labor.Nitrous oxide group(n=251).50% nitrous oxicle in oxygen was inhalated during labor.Control group(n=184)analgesic was not used.The degree of labor pain,duration of the labor,way of delivery,bleeding volume and the condition of the fetus and newborn among 3 groups were served.Results: The effect for labor pain relief of the 3 groups,there were significant difference(P<0.01).The duration for analgesia labor of the epidural analgesia group was much better than that of the nitrous oxide group(P<0.01).In the first stage of labor,the epidural analgesia group and nitrous oxide group(P>0.05),were shorter than the control group(P<0.05).The rate of vaginal operaion of the epidural analgesia group was higher than the others(P<0.01).Conclusion:The effectiveness of the epidural analgesia for analgesia labor is confined and has rarely side-effeCt,it can be used in the normal pregnant women and the women with pregnancy induced hypertension.The inhalation of nitrous oxide can safely provide effection labor analgesia,too.更多还原