低背景剂量联合大剂量自控镇痛方案对足月初产妇镇痛效果的影响  

Analgesic Effect of Low Background Dose Plus High-Dose Patient-Controlled Analgesia in Full-Term Primiparas

作　　者：曾祥鑫 罗荣 王伟昌[1] 胡永和 ZENG Xiang-xin;LUO Rong;WANG Wei-chang;HU Yong-he(Department of Anesthesiology I,Meizhou People's Hospital,Meizhou 514031,China;Department of Obstetrics,Meizhou People's Hospital,Meizhou 514031,China)

机构地区：[1]梅州市人民医院麻醉一科,梅州514031 [2]梅州市人民医院产科,梅州514031

出　　处：《中国合理用药探索》2023年第11期99-103,共5页Chinese Journal of Rational Drug Use

摘　　要：目的:探讨低背景剂量联合大剂量患者自控镇痛(PCA)方案对足月初产妇镇痛效果的影响。方法:回顾性选取2018年1月~2020年10月期间于某院分娩的172例足月初产妇作为研究对象,根据硬膜外分娩方案分为对照组(n=90)和试验组(n=82)。对照组采用常规硬膜外分娩镇痛方案,试验组采用低背景剂量联合大剂量PCA方案。比较两组产程时间、视觉模拟评分法(VAS)评分、分娩镇痛时间、PCA按压次数、麻醉药物用量情况、分娩后不同时间健康调查简表(SF-36)评分。结果:两组第一、第二及第三产程时间比较均无统计学差异(P>0.05)。两组镇痛前后VAS评分、分娩镇痛时间比较均无统计学差异(P>0.05)。试验组实际/有效PCA按压次数、麻醉药物使用量均低于对照组(P<0.05)。试验组分娩后1个月、3个月SF-36评分均高于对照组(P<0.05)。结论:对于足月初产妇的分娩过程,常规镇痛方案与低背景剂量联合大剂量PCA方案的镇痛效果较为接近,但低背景剂量联合大剂量PCA方案的麻醉药物使用量更低,有望获得更高的安全性。Objective:To investigate the analgesic effect of low background dose plus high-dose patient controlled analgesia(PCA)in full-term primiparas.Methods:A total of 172 full-term primiparas who had a delivery of baby in a hospital from January 2018 to October 2020 were retrospectively selected as the study subjects and divided into a control group(n=90)and an experimental group(n=82)according to the epidural procedure.The control group was treated with conventional epidural anesthesia,and the experimental group was treated with low background dose plus high-dose PCA.The duration of stage of labor,the visual analogue scale(VAS)score,the duration of labor analgesia,the number of compression during PCA,the dosage of anesthetics,and the MOS item short from health survey(SF-36)scores at different time points after labor were compared between the two groups.Results:There was no statistically significant difference in the duration of the first,second or third stage of labor between the two groups(P>0.05).There was no statistically significant difference in VAS score or the duration of labor analgesia between the two groups before and after analgesia(P>0.05).The values for the number of actual/effective PCA compression and the dosage of anesthetics were lower in the experimental group than that in the control group(P<0.05).The experimental group had higher SF-36 scores at 1 month and 3 months after labor than the control group(P<0.05).Conclusion:Although conventional anesthesia and low background dose plus high-dose PCA produced a comparable analgesic effect in full-term primiparas during the process of labor,the combination of low background dose plus high-dose PCA required a lower dose of anesthetics and is expected to provide higher safety.

关 键 词：硬膜外镇痛 分娩镇痛 产妇 自控镇痛 麻醉药物 

分 类 号：R714.3[医药卫生—妇产科学]