吴霞 何明枫

[摘要]目的 探討瑞芬太尼静脉自控镇痛麻醉用于初产妇分娩镇痛的临床效果。方法 选取2018年7月～2019年8月我院收治的60例初产妇作为研究对象，按照随机数字表法将其分为两组，每组各30例。对照组实施硬膜外阻滞自控镇痛麻醉方法，研究组实施瑞芬太尼静脉自控镇痛麻醉方法。观察比较两组初产妇的镇痛效果，比较两组不同时间段的视觉模拟量表（VAS）评分、心率（HR）及平均动脉压（MAP），比较两组的不良分娩结局以及不良反应情况。结果 研究组的镇痛优良率高于对照组，差异有统计学意义（P<0.05）;两组镇痛前的VAS评分、HR、MAP比较，差异无统计学意义（P>0.05）;研究组镇痛后15、30、60 min的VAS评分、HR、MAP均低于对照组，差异有统计学意义（P<0.05）;两组的不良分娩结局总发生率比较，差异无统计学意义（P>0.05）;两组的不良反应总发生率比较，差异无统计学意义（P>0.05）。结论 实施瑞芬太尼静脉自控镇痛麻醉方法有助于改善初产妇的疼痛程度，改善相关症状指标，提高镇痛优良率，而且不增加不良分娩结局发生率，有重要临床应用价值。

[关键词]瑞芬太尼;静脉自控镇痛麻醉;初产妇;分娩镇痛

[中图分类号] R614.42          [文献标识码] A          [文章编号] 1674-4721（2020）7（b）-0156-04

Clinical effect of Remifentanil intravenous controlled analgesia anesthesia on labor analgesia in primiparae

WU Xia   HE Ming-feng

Department of Anesthesiology and Perioperative Medicine， the First Affiliated Hospital of Nanjing Medical University， Jiangsu Province， Nanjing   210029， China

[Abstract] Objective To investigate the clinical effect of Remifentanil intravenous controlled analgesia anesthesia on labor analgesia in primiparae. Methods From July 2018 to August 2019， 60 cases of primiparae admitted in our hospital were selected as the study objects. According to the random number table method， they were divided into two groups， 30 cases in each group. The control group underwent epidural block controlled analgesia anesthesia method， and the study group underwent Remifentanil intravenous controlled analgesia anesthesia method. The analgesic effect of primiparae between the two groups were observed and compared. Visual analogue scale （VAS） scores， heart rates （HR）， and mean arterial pressure （MAP） were compared between the two groups at different time periods. Adverse birth outcomes and adverse reactions were compared between the two groups. Results The excellent and good rate of analgesia in the study group was higher than that in the control group， the difference was statistically significant （P<0.05）. There were no significant differences in VAS scores， HR， and MAP between the two groups before analgesia （P>0.05）. The VAS scores， HR， and MAP in the study group were lower than those in the control group at 15， 30 and 60 min after analgesia， the differences were statistically significant （P<0.05）. There was no significant difference in the total incidence of adverse delivery outcome between the two groups （P>0.05）. There was no significant difference in the overall incidence of adverse reactions between the two groups （P>0.05）. Conclusion The application of Remifentanil intravenous controlled analgesia anesthesia is helpful to improve the pain degree of primiparae， improve the related symptom indicators， increase the good and good rate of analgesia， and do not increase the incidence of adverse delivery outcome， which has important clinical application value

[Key words] Remifentanil; Intravenous controlled analgesia anesthesia; Primiparae; Labor analgesia

随着社会经济的持续发展以及医疗水平的促进提升，人们的生活质量不断提高，因此人们对临床医疗舒适度也有更严格的要求。分娩疼痛对产妇的身心均造成极大痛苦，而分娩镇痛可以有效缓解产妇因分娩而造成的痛苦[1-2]。产妇分娩疼痛属于女性最恐惧疼痛、最难忍受的疼痛类型之一。随着临床医学的持续进步、分娩镇痛技术加快发展等各种因素影响，同时分娩镇痛过程中需顾及产妇母体健康以及胎儿健康，临床分娩过程中越来越多地运用各种科学的镇痛手段[3-4]。目前……