Spinocath导管鞘内连续给药分娩镇痛的临床观察

Continuous spinal anesthesia and spinal and epidural anesthesia for labor analgesia

目的观察Spinocath导管鞘内连续给药分娩镇痛的临床应用效果。方法选择初产妇52例,随机分A组和B组,各26例。A组蛛网膜下腔注射8μg舒芬太尼,待产妇VAS≥3分时启用自控PCA泵维持镇痛,鞘内用药为0.4μg/ml的舒芬太尼;B组按产科常规处理,不给任何镇痛药物。观察A组的镇痛起效时间、鞘内首次给药镇痛持续时间、运动阻滞、镇痛满意度等;观察两组的各时间点VAS评分、产程时间、出血量、新生儿Apgar评分、分娩方式、不良反应等。结果 A组鞘内首次给药镇痛持续时间较长,产后头痛发生率高达57.6%。结论微量舒芬太尼Spinocath导管鞘内连续给药分娩镇痛方法具有起效快、镇痛效果良好等优点,能缩短产程,运动神经无阻滞,降低剖宫产率,对新生儿无不良影响。但Spinocath导管鞘内连续给药分娩镇痛产后头痛发生率高且费用略显昂贵。

Objective To observe the effect of spinal subarachnoid catheter continuous spinal anesthesia for labor analgesia.Methods 52 pregnant patient were randomly divided into 2 groups：with 26 cases in each group.Group A were received spinal anesthesia using sulfentanil 8μg and startup PCA with 0.4μg/ml sulfentanil when VAS≥3.Group B did not be given any analgesia medicine.The time to onset analgesia,hold up time of analgesic action,the situation for blockade for and analgesia degree of satisfaction were measured in group A.The different time spot for VAS,course of childbirth time,hemorrhage quantity,newborn apgar grading,childbirth way and the untoward effect were observed.Results Intrathecal administration of analgesia last long in group A,but with 57.6% childbirths headache formation rate.Conclusion Micro sulfentanil in spinocath subarachnoid catheter continuous spinal anesthesia for painless labor has,the quick and good analgesic effect,can reduce the course of childbirth and splits the palace production rate,does not hinder the efferent nerve,does not have adverse effect on the newborn,but with high post-natal headache formation rate and expensive cost.