硬膜外镇痛分娩追加阴部神经阻滞麻醉的麻醉效果  

Anesthesia effect of labor epidural analgesia with additional pudendal nerve block anesthesia

作　　者：张红茹[1] 王娜[1] 卢俊红[1] ZHANG Hongru;WANG Na;tU Junhong(Department of Obstetrics and Gynecology, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100050, China)

机构地区：[1]首都医科大学附属北京天坛医院妇产科,北京100050

出　　处：《中国现代医生》2017年第30期112-114,共3页China Modern Doctor

摘　　要：目的探讨实施硬膜外麻醉追加阴部神经阻滞麻醉对实施会阴侧切产妇的麻醉效果。方法选取行会阴侧切的分娩产妇100例,使用随机数字表法分为观察组和对照组各50例。对照组产妇实施常规硬膜外镇痛分娩加会阴侧切。观察组产妇在硬膜外镇痛于会阴侧切前3 min,追加2%利多卡因10 m L+灭菌注射用水10 m L用于阴部神经阻滞麻醉。比较两组患者的会阴侧切及缝合时疼痛情况和产后会阴部水肿情况。结果观察组比对照组的镇痛效果更好,会阴侧切及缝合时长海痛尺表评分明显优于对照组(P<0.05),产后局部组织水肿分级情况也优于对照组(P<0.05)。结论行硬膜外镇痛分娩追加阴部神经阻滞麻醉有效地减轻了产妇分娩时会阴侧切的疼痛,减少了切口水肿,促进了伤口愈合,具有较好的临床应用价值。Objective To investigate the anesthesia effect of epidural anesthesia plus pudendal nerve block anesthesia on the puerperas with lateral episiotomy. Methods 100 delivery puerperas who underwent lateral episiotomy were divid-ed into observation group（n=50） and control group（n =50） by random number table method. The control group was treat- ed with conventional labor epidural analgesia and lateral episiotomy. The observation group was treated with epidural analgesiaand added with 2% lidocaine 10 mt＋10 mt of sterile water for pudendal nerve block anesthesia at 3 minutes before lateral episiotomy. The pain situation at lateral episiotomy and suture and the postpartum perineal edema be- tween the two groups were compared. Results The analgesic effect of the observation group was better than that of the control group. The score of Changhai pain rulerat lateral episiotomy and suture in the observation group was signifi- cantly better than that of the control group（P〈0.05）. And postpartum local tissue edema classification was better than that of the control group（P〈0.05）. Conclusion Epidural analgesia with the addition of pudendal nerve block anesthesia effectively reduces the pain oflateral episiotomy when the puerperas underwent delivery, which reduces the incision edema, promotes wound healing, and has a good clinical application value.

关 键 词：硬膜外镇痛 阴部神经阻滞麻醉 会阴侧切 疼痛 水肿 

分 类 号：R614[医药卫生—麻醉学]