全产程腰-硬联合阻滞分娩镇痛的临床应用(1)
【摘 要】 目的:探讨全产程腰-硬联合阻滞分娩镇痛的可行性。方法:选择初产妇60例,分两组,A组(全产程组,宫口开张1～1.5cm)和B组(活跃期组,宫口开张2～3cm),每组30例。两组均采用蛛网膜下腔给药后硬膜外腔留管产妇自控镇痛(CSE+PCA),两组的蛛网膜下腔给药和硬膜外腔维持用药相同。观察记录镇痛时间、镇痛起效时间、不同时间的VAS评分、运动阻滞、各组产程、出血量、新生儿Apgar评分、镇痛满意度、分娩方式、不良反应等指标。结果:A组潜伏期时间短于B组(P<0.05);B组的镇痛起效时间快于A组(P<0.05);A组的镇痛时间比B组长(P<0.05),但两组镇痛药的总用量比较无显著性差异(P>0.05)。结论:全产程腰-硬联合阻滞分娩镇痛效果确切,不良反应少,可缩短产程,对产妇和新生儿无不良影响。【关键词】 全产程 分娩镇痛 蛛网膜下腔 硬膜外腔 舒芬太尼
Clinical application of whole production process combined spinal-epidural block analgesia
Zhou Chaoming,et al
【Abstract】 Objective: To study the feasibility of combined spinal-epidural anesthesia (CSEA) for entire delivery analgesia. Method:Sixty primiparas were selected and divided into two groups: group A (entire delivery group with cervix opening for about 1cm) and group B (active period group with cervix opening for about 2~3cm), with each of these groups own 30 samples. Both of the two groups apply combined spinal epidural anesthesia and patient-controlled analgesia methods (CSE+PCA) with the amount of subarachnoid and epidural anesthesia maintain at the same level. The following variables are recorded during the observation: analgesia time, analgesic onset time, VAS score at different times, motor block, delivery period of each group, amount of bleeding, neonatal Apgar score, analgesic satisfaction, delivery mode, adverse reactions, etc. Results:The latent period for group A is shorter than group B (P<0.05); the analgesic onset time for group B is faster than group A (P<0.05), and the analgesia time for group A is shorter than group B (P<0.05), while the total amount of anesthesia for both of the groups have no obvious difference (P>0.05). Conclusions:The effect of CSEA is positive - it seldom has side effect, can shorten the delivery period, and has no adverse effect on puerperas and newborns. ......
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