摘要
目的:观察硬脊膜穿破硬膜外(dural puncture epidural,DPE)阻滞对比传统硬膜外(epidural,EP)阻滞技术用于产妇分娩镇痛的效果。方法:纳入2019年10月至2020年9月在常州市妇幼保健院自然分娩并行分娩镇痛的初产妇178例。随机分为EP组(n=89,实施硬膜外镇痛)与DPE组(n=89,实施硬脊膜穿破硬膜外镇痛),两组均予以0.1%罗哌卡因+0.5μg/mL舒芬太尼镇痛方案。记录两组镇痛前、用药30 min和90 min时的疼痛视觉模拟量表(Visual Analogue Scale,VAS)评分;记录两组分娩镇痛情况及产妇产程时间、分娩方式及不良反应;记录两组新生儿Apgar评分,并对比两组新生儿脐动脉血气分析情况。结果:DPE组给药后30 min和90 min时的VAS评分均显著低于EP组(P<0.05);相比EP组,DPE组自控镇痛(patient-controlled analgesia,PCA)按压次数及舒芬太尼、罗哌卡因用量均显著减少(P<0.05),缩宫素使用率显著降低(P<0.05);两组产妇产程时间、分娩方式对比差异无统计学意义(P>0.05);DPE组不良反应发生率显著低于EP组,差异有统计学意义(P<0.05);两组新生儿Apgar评分及脐动脉血气分析比较差异均无统计学意义(P>0.05)。结论:相比EP阻滞镇痛,DPE阻滞应用于产妇分娩镇痛中能够提供更好的镇痛效果,能够减少用药量和不良反应,且不影响产程和母婴结局。
Objective:To observe the effect of dural puncture epidural(DPE)technique compared with traditional epidural(EP)technique in maternal labor analgesia.Methods:A total of 178 primiparas with natural childbirth and labor analgesia in Changzhou Maternal and Child Health Care Hospital from October 2019 to September 2020 were included.They were randomly divided into EP group(n=89,epidural analgesia)and DPE group(n=89,dural puncture epidural analgesia),and both groups were given 0.1%ropivacaine+0.5μg/mL sufentanil analgesia.The Visual Analogue Scale(VAS)scores before,30 min and 90 min after epidural analgesia were recorded;the labor analgesia,labor time,mode of delivery and adverse reactions of the two groups were recorded;the Apgar scores of the two groups were recorded;and the umbilical artery blood gas analysis of the two groups was compared.Results:The VAS score at 30 min and 90 min after administration in the DPE group were significantly lower than those in the EP group(P<0.05).Compared with the EP group,the number of PCA and the dosage of sufentanil and ropivacaine in the DPE group were significantly decreased(P<0.05),and the use rate of oxytocin was significantly decreased(P<0.05).There were no significant difference in labor time and delivery mode between the two groups(P>0.05).The incidence of adverse reactions in the DPE group was significantly lower than that in the EP group,and the difference was statistically significant(P<0.05).There were no significant difference in Apgar score and umbilical artery blood gas analysis between the two groups(P>0.05).Conclusion:Compared with EP technique,DPE technique can provide better analgesic effect in maternal labor analgesia,reduce dosage,reduce adverse reactions,and does not affect the labor process as well as maternal and infant outcomes.
作者
黄云波
徐晓义
丁杰
HUANG Yunbo;XU Xiaoyi;DING Jie(Department of Anesthesiology,Changzhou Maternal and Child Health Care Hospital,Changzhou Jiangsu 213000,China)
出处
《临床与病理杂志》
CAS
2022年第5期1105-1110,共6页
Journal of Clinical and Pathological Research
