The effect of remifentanil for labor analgesia and its effect on pregnancy outcome / 中国综合临床

ABSTRACT

Objective To investigate the effects of remifentanil patient controlled intravenous analgesia (PCIA) as a labour analgesic and the effects of neonate.Methods One hundred and thirty-five vaginal delivery primiparas were randomly divided into 3 groups: natural labor group, remifentanil l(RI) group and remifentanil Ⅱ(R Ⅱ) group,each group of 45 cases.RⅠ group and R Ⅱ group were treated with remifentanil at initial dose of 0.5 μg/kg and background dose of 0.05 μg/(kg? min) respectively.Patients in RⅠ group were treated with bolus dose of 0.2 μg/kg.Patients in R Ⅱ group were treated with bolus dose of 0.5 μg/kg.The lock time was 2 minutes.The analgesic effect of before analgesia immediate, and 5,30,60 min after analgesia were evaluated by visual analogue scale (VAS).And the oxytocin usage rate, cesarean section rate, neonatal Apgar score were assessed.The adverse drug reactions were recorded.Results After 5,30,60 min used drug , compared with natural labor group((9.52±0.32) sore, (9.58±0.27) sore, (9.53±0.28) sore) ,the VAS were decreased in the group of RⅠ((7.19±0.53) sore, (5.82±0.48) sore, (5.25±0.54) sore) and R Ⅱ (P＜0.05).Compared with RⅠ group,the VAS were decreased in the group of R Ⅱ (P＜0.05).There were no differences of oxytocin usage rate,cesarean section rate,neonatal Apgar score.In the remifentani] group, there were 2 cases of pruritus and 1 cases of vomiting;the systolic blood pressure and heart rate were in the normal physiological range after analgesia.Abnormal fetal heart rate was not found during the routine fetal heart monitoring during analgesia.Conclusion Patient-controlled intravenous analgesia with remifentanil is effective in labour analgesia and at initial dose of 0.5 μg/kg,background dose of 0.05 μg/(kg? min) and bolus dose of 0.5 μg/kg for 2 min.