程控间歇硬膜外脉冲输注技术对自然分娩初产妇睡眠质量及分娩镇痛的影响  

Effect of programmed intermittent epidural bolus technique on sleep quality and labor analgesia of primiparas in natural delivery

作　　者：钟永灿 郭志杰 陈桂培 蔡水民 ZHONG Yongcan;GUO Zhijie;CHEN Guipei;CAI Shuimin(Department of Anesthesiology,Jinjiang Hospital of Traditional Chinese Medicine,Fujian Province,Jinjiang 362200,China)

机构地区：[1]福建省晋江市中医院麻醉科,福建晋江362200

出　　处：《中国当代医药》2025年第1期63-67,共5页China Modern Medicine

摘　　要：目的观察程控间歇硬膜外脉冲输注(PIEB)技术对自然分娩初产妇睡眠质量及分娩镇痛的影响。方法选取2022年2月至2024年2月在晋江市中医院接受硬膜外分娩镇痛的180例初产妇进行回顾性分析,根据镇痛维持阶段给药模式不同将产妇分为PIEB组与持续硬膜外输注组(CEI组),每组90例。记录宫口开全时的视觉模拟评分法(VAS)评分、产妇自控硬膜外镇痛(PCEA)有效按压次数、罗哌卡因总用量、麻醉医生追加给药的例数、产妇整体满意度以及并发症的发生情况。记录镇痛前和镇痛后的匹兹堡睡眠质量指数(PSQI)评分。结果PIEB组宫口开全时VAS评分低于CEI组,PCEA有效按压次数少于CEI组,罗哌卡因总用量少于CEI组,麻醉医生追加给药比例低于CEI组,产妇整体满意度高于CEI组,镇痛后PSQI评分低于CEI组,差异有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论在初产妇自然分娩过程中,采用PIEB技术用于硬膜外分娩镇痛可提供更完善的镇痛效果,有助于改善初产妇的睡眠质量。Objective To observe the effect of programmed intermittent epidural bolus(PIEB)on sleep quality and labor analgesia of primiparas in natural delivery.Methods A total of 180 primiparas who received epidural analgesia in Jinjiang Hospital of Traditional Chinese Medicine from February 2022 to February 2024 were analyzed retrospectively.They were divided into PIEB group and continuous epidural infusion group(CEI group)with 90 cases in each group according to different medication modes during the analgesia maintenance stage.The visual analogue scale(VAS)score when the uterine neck completely dilated,the effective pressing times of patient-controlled epidural analgesia(PCEA),the total dosage of ropivacaine,the number of additional drugs given by anesthesiologists,the overall satisfaction of parturients and the occurrence of complications were recorded.The scores of Pittsburgh sleep quality index(PSQI)before and after analgesia were recorded.Results The VAS score of the PIEB group was lower than that of the CEI group when the uterine neck completely dilated,the effective pressing times of PCEA was less than that of the CEI group,the total dosage of Ropivacaine was less than that of the CEI group,the proportion of additional drugs given by anesthesiologists was lower than that of the CEI group,and the overall satisfaction of parturient was higher than that of the CEI group,and the PSQI score after analgesia was lower than that of the CEI group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion During the natural delivery of primiparas,the use of PIEB technique for epidural labor analgesia can provide a better analgesic effect and help to improve the sleep quality of primiparas.

关 键 词：分娩镇痛 程控间歇硬膜外脉冲输注 持续硬膜外输注 镇痛效果 睡眠质量 

分 类 号：R614[医药卫生—麻醉学]