Clinical investigation on patient-controlled epidural analgesia with low dose ropivacaine combined with fentanyl in labor / 医学研究生学报

ABSTRACT

Objective:To evaluate the analgesic effect of low dose ropivacaine combined with fentanyl in patient controlled epidural analgesia (PCEA) and its influence on labor and safety of mothers and their newborns. Methods:One hundred and forty healthy nullipara at term were randomly assigned to epidural analgesia or control group. The analgesia group received PCEA when their labor stage reached active period in the first stage of labor.The PCEA mode was background infusion 6 ml/h, bonus 2 ml,lockout time 10 min/each infusion. The VAS, modified Bromage scale(MBS),duration and mode of labor, postpartum hemorrhage,Apgar scores of newborns were recorded. Results:Fifteen minutes after application of PCEA,98.58% of patients felt no pains(VAS 0.057?0.48),only 4.8% showed a mild motor block(MAS 0.07?0.31).By the 60 min,all patients could move the lower limbs freely (MAS 0). The analgesia group had a significantly shorter duration of active period in the first stage of labor than that of the control group, but a significant longer duration of the second stage. In addition, the oxytocin usage was significantly more frequently in analgesia group than those in placebo group.There was no difference between the two groups in the duration of third stage, postpartum hemorrhage, Apgar scores of newborns in 1 min and 5 min, rate of cesarean section and instrumental delivery.Conclusion:Epidural analgesia with low dose ropvicaine combined with fentanyl is safe and effective, which has no influence on mothers and their infants. It could shorten the active period of labor, but may increase oxytocin usage. The ratio of cesarean section and instrumental delivery was similar between the two groups. This kind of labor analgesia is beneficial and do no harm to mothers as well as newborns.