不同给药方式用于分娩镇痛的效果研究  

Efficacy of different administration methods for labor analgesia

作　　者：李会会 赵利芳[1] 范解放[1] Li Huihui;Zhao Lifang;Fan Jiefang(Department of Anesthesiology and Perioperative Medicine,Xinxiang Central Hospital,Xinxiang 453000,HenanProvince,China)

机构地区：[1]新乡市中心医院麻醉与围术期医学科,新乡453000

出　　处：《中国基层医药》2024年第2期239-242,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨不同给药方式用于分娩镇痛的临床效果。方法选取新乡市中心医院2023年2—6月经阴道分娩的产妇152例进行随机对照研究,按照随机数字表法分为对照组、观察组各76例。对照组常规硬膜外置管后给予0.1%盐酸罗哌卡因3 mL,并于3 min后予镇痛药物3 mL,无特殊反应者3 min后给予镇痛泵内药物9 mL并连接镇痛泵,开启至分娩后拔出导管。观察组导管置入硬膜外腔前给予试验量0.1%盐酸罗哌卡因3 mL,常规置入硬膜外导管,3 min后产妇躺平再次给予镇痛泵内药物3 mL,3 min后给予镇痛泵内药物9 mL,连接镇痛泵并开启至分娩后拔出导管。观察两组硬膜外置管不畅发生率,产妇硬膜外穿刺前(T1)、镇痛开始30 min(T2)、宫口开全(T3)3个时间点的视觉模拟评分法(VAS)评分,产妇自主追加镇痛泵次数,产妇满意度,转剖宫产例数,恶心呕吐、发热等不良反应发生率以及新生儿Apgar评分。结果观察组置管不畅发生率为1.3%(1/76),显著低于对照组的10.5%(8/76)(χ^(2)=5.79,P<0.05)。观察组T2、T3时间点的VAS评分分别为(0.89±0.08)分、(2.1±0.07)分,均低于对照组的(2.55±0.07)分、(3.35±0.07)分(t=238.54、133.17,均P<0.001)。观察组自主追加镇痛泵次数[(1.00±0.84)次]少于对照组[(4.00±0.65)次](t=29.47,P<0.001)。观察组产妇满意度[100.0%(76/76)]高于对照组[92.1%(70/76)](χ^(2)=6.25,P<0.05),转剖宫产率为0(0/76),低于对照组的52.6%(4/76)(χ^(2)=4.10,P<0.05)。结论行硬膜外置管分娩镇痛时于置入硬膜外导管前给予试验量0.1%盐酸罗哌卡因3 mL有利于置管且可显著提高分娩镇痛效果,有一定的应用价值。Objective To investigate the clinical efficacy of different administration methods for labor analgesia.Methods This randomized controlled study was conducted on 152 parturient women who underwent vaginal delivery at the Xinxiang Central Hospital from February to June 2023.These women were divided into a control group and an observation group,with 76 women per group.Women in the control group received 3 mL of 0.1%ropivacaine hydrochloride after routine epidural catheterization,followed by 3 mL of analgesic drugs after 3 minutes.For those without any special reactions,an analgesic pump containing 9 mL of medication was used after 3 minutes until the end of labor.In the observation group,3 mL of 0.1%ropivacaine hydrochloride was administered as a trial dose before the epidural catheter was inserted into the epidural space.After 3 minutes,the postpartum woman lay flat and was given another 3 mL of analgesic pump medication.After 3 additional minutes,an additional 9 mL of the medication was administered.The analgesic pump was connected and turned on until the catheter was removed after delivery.The epidural catheter failure rate was assessed in each group.Before epidural puncture(T1),within 30 minutes after the onset of anesthesia(T2),and at the time of full dilation of the cervix(T3),Visual Analogue Scale scores,the number of patient attempts to additionally use an analgesia pump,maternal satisfaction,the number of cases requiring cesarean section conversion,the incidence of adverse reactions(such as nausea,vomiting,and fever),and Apgar scores for newborns were recorded in each group.Results The epidural catheter failure rate in the observation group was 1.3%(1/76),which was significantly lower than 10.5%(8/76)in the control group(χ^(2)=5.79,P<0.05).At T2 and T3,the Visual Analogue Scale score in the observation group was(0.89±0.08)points and(2.1±0.07)points,respectively,which were significantly lower than(2.55±0.07)points and(3.35±0.07)points in the control group(t=238.54,133.17,both P<0.001).The number of pati

关 键 词：麻醉和镇痛 镇痛 硬膜外 镇痛 产科 镇痛 病人控制 疼痛测定 阿普加评分 随机对照试验 

分 类 号：R714.3[医药卫生—妇产科学]