腰硬联合麻醉与持续硬膜外麻醉在分娩镇痛中的应用效果分析  

Effect analysis of combined spinal-epidural anesthesia and continuous epidural anesthesia in labor analgesia

作　　者：王云龙 罗焕光 赖礼达 WANG Yun-long;LUO Huan-guang;LAI Li-da(Department of Anesthesiology,Meizhou Third People’s Hospital,Meizhou 514000,China)

机构地区：[1]梅州市第三人民医院麻醉科,514000

出　　处：《中国现代药物应用》2021年第23期45-47,共3页Chinese Journal of Modern Drug Application

摘　　要：目的 研究腰硬联合麻醉与持续硬膜外麻醉在分娩镇痛中的应用效果。方法 60例要求无痛分娩产妇,随机分为对照组和观察组,每组30例。对照组使用持续硬膜外麻醉,观察组使用腰硬联合麻醉。对比两组产妇起效时间与视觉模拟评分法(VAS)评分,新生儿不同时间段Apgar评分,产程时间,转剖宫产率。结果 观察组起效时间(3.75±0.36)min短于对照组的(10.26±2.85)min,麻醉5、10、30、60 min的VAS评分分别为(3.78±0.52)、(1.53±0.27)、(1.32±0.24)、(1.69±0.52)分,明显低于对照组的(8.54±2.69)、(4.69±1.58)、(3.76±1.62)、(2.87±1.03)分,差异具有统计学意义(P<0.05)。观察组新生儿出生1、5、10 min的Apgar评分与对照组对比,差异无统计学意义(P>0.05)。观察组活跃期、第二产程和第三产程时间均明显短于对照组,差异具有统计学意义(P<0.05)。观察组转剖宫产率为3.33%,明显低于对照组的20.00%,差异具有统计学意义(P<0.05)。结论 产妇进行无痛分娩时使用腰硬联合麻醉镇痛效果更为理想,麻醉起效时间更快,安全性更高,更利于顺利分娩,值得临床推广。Objective To study the effect of combined spinal-epidural anesthesia and continuous epidural anesthesia in labor analgesia.Methods A total of 60 women who required painless delivery were randomly divided into the control group and the observation group,with 30 cases in each group.The control group used continuous epidural anesthesia,and the observation group used combined spinal-epidural anesthesia.Both groups were compared in terms of onset time,visual analogue scale(VAS)score,neonatal Apgar score at different time points,labor time,and cesarean section rate.Results The onset time(3.75±0.36)min of the observation group was shorter than(10.26±2.85)min of the control group;the VAS scores of the observation group were(3.78±0.52),(1.53±0.27),(1.32±0.24)and(1.69±0.52)points after 5,10,30,and 60 min of anesthesia,which were significantly lower than(8.54±2.69),(4.69±1.58),(3.76±1.62),(2.87±1.03)points of the control group;all the differences were statistically significant(P<0.05).There was no statistically significant difference in neonatal Apgar scores between the observation group and the control group at 1,5,and 10 min after birth(P>0.05).The time of active phase,second stage of labor and third stage of labor in the observation group were significantly shorter than those in the control group,and the difference was statistically significant(P<0.05).The cesarean section rate in the observation group was 3.33%,which was significantly lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Combined spinal-epidural anesthesia can obtain more ideal analgesic effect in parturients with faster onset time and higher safety,which is more conducive to smooth delivery and worthy of clinical promotion.

关 键 词：腰硬联合麻醉 持续硬膜外麻醉 分娩镇痛 

分 类 号：R714.3[医药卫生—妇产科学]