摘要
目的:探讨硬膜外阻滞分娩镇痛中持续/间断两种给药方式对产妇运动和妊娠结局的影响.方法:选取我院2018年1月~2018年9月期间60例行硬膜外阻滞分娩镇痛的产妇,均无产科和麻醉相关禁忌症.根据硬膜外麻醉给药方式不同,将其分为间歇注药组(n=30)和连续注药组(n=30),观察两组麻醉用药、PCEA使用及不同时点镇痛效果,重点观察两组运动神经阻滞发生情况和产妇分娩结局等指标,并记录相关不良反应情况.结果:间歇注药组罗哌卡因+舒芬太尼使用量、PCEA使用次数均显著低于连续注药组,但两组在镇痛后30min、1h、3h、5h、7h的VAS评分相较差异并无统计学意义;间歇注药组在镇痛后3h、5h、7h的运动阻滞发生率均显著低于连续注药组,且需要器械辅助分娩率、剖宫产率也均低于连续注药组,差异均具有统计学意义;间歇注药组分娩阵痛期间不良反应率16.67%(5/30)和连续注药组23.33%(7/30)相较差异无统计学意义,两组整体安全性均较好.结论:硬膜外间歇注药减少了麻醉药物用量,可达到和连续注药相接近的麻醉镇痛效果,有效减少产妇运动神经阻滞的发生,对减轻产妇痛苦、帮助胎儿正常分娩具有显著作用.
Objective To investigate the effect of two continuous/intermittent drug delivery methods in epidural analgesia on maternal movement and pregnancy outcome.Methods 60 parturients with epidural analgesia during the period of January 2018~2018 and May were selected in our hospital without obstetrics and anesthetic related contraindications.According to the different methods of epidural anesthesia,it was divided into intermittent injection group(n=30)and continuous injection group(n=30).The analgesic effects of two groups of anesthetic drugs,PCEA use and different time points were observed.The occurrence of motor nerve block and delivery outcome of two groups were observed,and the related adverse reactions were recorded.Results The intermittent injection group of ropivacaine combined with sufentanil consumption,PCEA times were significantly lower than those in continuous infusion group,but the two groups in 30min,1h,3h,5h after analgesia,7h VAS score compared with no significant difference;motor block intermittent injection group in 3h,5h,analgesia the incidence of 7h was significantly lower than that in continuous infusion group,and the need of instrument assisted delivery rate,cesarean section rate was lower than the continuous infusion group,the differences were statistically significant;during the intermittent injection group tocogram adverse reaction rate of 16.67%(5/30)and continuous infusion group(23.33%7/30)compared with no significant difference,two group had better safety.Conclusion Epidural intermittent injection reduces the dosage of narcotic drugs,and achieves anaesthesia analgesia effect similar to continuous injection.It effectively reduces the occurrence of motor nerve block and has a significant effect on relieving maternal pain and helping the normal delivery of fetus.
作者
杨坤渹
李扬
易勤美
Yang Kun-qing;Li Yang;Yi Qin-mei(Department of anesthesia,Hubei University for Nationalities Affiliated Minda Hospital,Enshi 445000,China)
出处
《湖南师范大学学报（医学版）》
2019年第4期86-90,共5页
Journal of Hunan Normal University(Medical Sciences)
关键词
硬膜外阻滞
分娩
给药方式
运动阻滞
分娩结局
epidural block
delivery
way of administration
motor block
delivery outcome
作者简介
通讯作者:杨坤渹,E-mail:108386507@qq.com
