硬膜外阻滞与氧化亚氮用于分娩镇痛疗效分析

    Effect of epidural block and nitrous oxide in analgesic labor

    • 摘要: 目的: 比较硬膜外阻滞与氧化亚氮吸入在分娩中的镇痛效果。方法: 硬膜外组稀释成0.2%罗哌卡因9 ml复合芬太尼1 ml,注入硬膜外腔,以后视产妇腹痛情况酌情追加5 ml。氧化亚氮组吸入50%氧化亚氮和50%氧气的混合气。结果: 两组镇痛效果在活跃期及第二产程差异有显著性(P<0.01),硬膜外组第二产程时间比氧化亚氮组长(P<0.05),两组第一产程、第三产程、分娩方式、产后出血、胎儿子宫内窘迫、新生儿窒息差异均无显著性(P>0.05),两组麻醉后血氧饱和度、舒张压差异均无显著性(P>0.05),而呼吸、心率和收缩压氧化亚氮组均高于硬膜外组(P<0.05~P<0.01)。结论: 硬膜外组镇痛效果明显优于氧化亚氮吸入组,但硬膜外组需专业麻醉师监护,第二产程有延长趋势,氧化亚氮组镇痛效果稍差,但不需专职麻醉师,产妇乐于接受,更适合在基层医院推广。

       

      Abstract: Objective: To compare the effect of epidural block and nitrous oxide in analgesic labor.Methods: Epidural block group were injected 0.2% ropivecaine 9 ml and fentanyl compound 1 ml in to the epidurale cavum and 5 ml mixture was added according to the maternity conditions.Nitrous oxide group 50% nitrous oxide and 50% oxygen.Results: The anesthetic effect differed significantly during the active period and the second labor stage(P<0.01).The time of second labor stage in the epidural block group was longer than that in nitrous oxide group(P<0.05).There was no significant difference in the first labor stage,the third labor stage,the mode of delivery,bleeding volumn,fetal distress and neonatal asphyxia(P>0.05).There was no significant difference in the oxygen saturation and diastolic pressure after anesthesia.The nitrous oxide group had higher respairatory rate,heart rate and systolic pressure than the epidural block group(P<0.05 to P<0.01).Conclusions: The anethestic effect of epidural block is much better than that of nitrous oxcide.Patients using epidural block must be monitored by a technical analgesist and the second birth process has the to extend.The anethetic effect of nitrous oxide is a bit weak,but the patients do not need a technical analgesist.Nitrous oxide is better accepted by the patient and the hospital at the basic level. Back

       

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