改良持续输注联合硬膜外自控给药方案对足月初产妇镇痛效果及麻醉药物用量的影响  

Influence of modified continuous infusion combined with epidural self-controlled administration on analgesic effect and anesthetic dosage in full-term primipara

作　　者：刘宇权 曾志文[1] 廖亿粦[1] 叶映芬 朱海坤 LIU Yuquan;ZENG Zhiwen;LIAO Yilin(Department of Anesthesiology,Meizhou People's Hospital,Guangdong Province,Meizhou 514031)

机构地区：[1]广东省梅州市人民医院麻醉科,梅州514031

出　　处：《陕西医学杂志》2020年第5期585-587,638,共4页Shaanxi Medical Journal

摘　　要：目的:探讨改良持续输注联合硬膜外自控给药方案对足月初产妇镇痛效果及麻醉药物用量的影响。方法:回顾性分析分娩足月初产妇共214例的临床资料,均行硬膜外分娩镇痛,其中127例采用常规方案镇痛设为对照组,即背景剂量6 ml/h,PCA剂量5 ml,每次间隔40 min;87例采用改良方案镇痛设为观察组,即背景剂量2 ml/h,PCA剂量10 ml,每次间隔40 min;比较两组产程时间、不同时间点VAS评分、镇痛时间、PCA次数、麻醉液用量及爆发痛发生率。结果:两组产程时间比较差异无统计学意义(P>0.05);两组不同时间点VAS评分比较差异无统计学意义(P>0.05);两组镇痛时间和爆发痛发生率比较差异无统计学意义(P>0.05);观察组患者实际PCA次数、有效PCA次数及麻醉液用量均显著少于对照组(P<0.05)。结论:改良持续输注联合硬膜外自控给药方案用于足月初产妇可获得与常规方案相近镇痛效果,且有助于减少麻醉药物用量。Objective:To investigate the influence of modified continuous infusion combined with epidural self-controlled administration on analgesic effect and anesthetic dosage in full-term primipara.Methods:The clinical data of 214 full-term primipara who underwent epidural labor analgesia were analyzed retrospectively.127 cases were given routine analgesia as the control group,and the background dose was 6 ml/h,the PCA dose was 5 ml,the interval time was 40 minutes.87 cases were given modified analgesia as the observation group,and the background dose was 2 ml/h,the PCA dose was 10 ml,the interval time was 40 minutes.The labor time,VAS score at different time points,analgesic time,times of PCA,dosage of anesthetic and incidence of outbreak pain were compared between the two groups.Results:There was no significant difference in the labor time,VAS score at different time points,analgesic time and the incidence of outbreak pain between the two groups(P>0.05).The actual times of PCA,the effective times of PCA and the dosage of anesthetic in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:The modified continuous infusion combined with epidural self-controlled administration for full-term primipara can achieve similar analgesic effect as the conventional administration and can help to reduce the dosage of anesthetic drugs.

关 键 词：硬膜外麻醉 初产妇 分娩镇痛 麻醉药物 镇痛效果 产程时间 

分 类 号：R614[医药卫生—麻醉学]