局部注射地塞米松对硬膜外分娩镇痛后腰背痛的预防效果研究  

Study on the effect of locally administered dexamethasone for prevention of low back pain after epidural labor analgesia

作　　者：谢谦谦 帅斐 XIE Qian-qian;SHUAI Fei(Department of Anesthesiology,Xiamen University Affiliated Women and Children's Hospital(Xiamen Maternal and Child Health Hospital),Xiamen 361000,China)

机构地区：[1]厦门大学附属妇女儿童医院(厦门市妇幼保健院)麻醉科,361000

出　　处：《中国现代药物应用》2025年第3期106-109,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探究局部注射地塞米松对硬膜外分娩镇痛后腰背痛的预防效果。方法选取施行硬膜外分娩镇痛的160例产妇为研究对象,通过随机数字表法将产妇分成D组和C组,每组80例。D组在硬膜外穿刺点周围注射地塞米松复合利多卡因,C组在硬膜外穿刺点周围注射1 ml 0.9%氯化钠注射液复合利多卡因。比较两组产后48、72 h腰背痛发生率及产后24 h疼痛程度、不同硬膜外穿刺次数腰背痛发生率。结果产后48h,D组有15例(18.75%)发生腰背痛,C组有31例(38.75%)发生腰背痛。产后72 h,D组与C组腰背痛的发生率分别为8.75%(7/80)、23.75%(19/80)。D组产后48、72 h腰背痛发生率均低于C组(P<0.05)。D组产后24h腰背痛的疼痛程度优于C组(P<0.05)。硬膜外穿刺次数为1次时,D组腰背痛发生率19.12%低于C组的37.14%(P<0.05);硬膜外穿刺次数>1次时,D组腰背痛发生率25.00%略低于C组的50.00%,但均无统计学差异(P>0.05)。结论硬膜外穿刺点局部注射地塞米松可降低分娩镇痛后腰背痛的发生率和疼痛程度,值得临床推广运用。Objective To explore the effect of locally administered dexamethasone for prevention of low back pain after epidural labor analgesia.Methods A total of 160 parturient who received epidural labor analgesia were selected as study subjects and assigned into group D and group C according to random numerical table,each with 80 cases.In group D,dexamethasone combined with lidocaine was injected around the epidural puncture point.In group C,1 ml 0.9%saline combined with lidocaine was injected around the epidural puncture point.The incidence of low back pain at 48 and 72 h postpartum,the pain severity at 24 h postpartum and the incidence of low back pain with different numbers of epidural punctures were compared between the two groups.Results At 48 h postpartum,group D had 15 cases(18.75%)of low back pain,and group C had 31 cases(38.75%)of low back pain.At 72 h postpartum,the incidence of lower back pain in group D and group C were 8.75%(7/80)and 23.75%(19/80).The incidence of lower back pain in group D was lower than that in group C at 48 and 72 h postpartum(P<0.05).The pain severity of low back pain in group D at 24 h postpartum was better than that in group C(P<0.05).The incidence of low back pain in group C was higher than that in group D when the number of epidural puncture was more than 1,but the difference was not statistically significant(P>0.05).When the number of epidural puncture was 1,the incidence of low back pain in group D(19.12%)was lower than that in group C(37.14%)(P<0.05).When the number of epidural puncture was>1,the incidence of low back pain in group D(25.00%)was slightly lower than that in group C(50.00%),but there was no statistical difference(P>0.05).Conclusion Local injection of dexamethasone at the epidural puncture point can reduce the incidence e of low back pain and pain severity after labor analgesia.It is worthy of clinical application.

关 键 词：地塞米松 硬膜外分娩镇痛 麻醉 腰背痛 局部注射 

分 类 号：R714.3[医药卫生—妇产科学]