椎管内阻滞用于分娩镇痛的研究进展

The research progress of intrathecal block for labor pain

背景椎管内阻滞用于分娩镇痛效果可靠，产妇满意度高，在产科麻醉中已经广泛流行。目的比较不同椎管内阻滞镇痛的方法，探讨分娩镇痛的前景。内容描述硬膜外阻滞、硬膜外自控镇痛（patient controlled epidural analgesia，PCEA）、腰硬联合阻滞（combined spinal-epidural analgesia，CSEA）、连续蛛网膜下腔阻滞（continuous spinal anesthesia，CSA）在分娩镇痛中的应用；硬膜外阻滞镇痛对产妇的影响；CSEA与PCEA的比较；CSEA潜在的并发症；CSA的神经系统并发症。趋向椎管内阻滞是实施分娩镇痛较为理想的方法。但是目前仍然没有一种绝对满意、安全、简单的分娩镇痛方法，有关的内容仍需进一步研究。

Background The effect of intrathecal block for labor pain is reliable, and maternal satisfaction is very high. This technology has attained wide spread popularity in obstetric anesthesia. Objective This paper compares the different methods of intratheeal block used for labor pain, and discusses the future perspectives of labor analgesia. Content This paper describes the applications of epidural anesthesia, patient controlled epidural analgesia （PCEA）, combined spinal-epidural analgesia（CSEA） and continuous spinal anesthesia （CSA） in labor analgesia, the influences of epidural anesthesia to parturient, the comparisons of CSEA and PCEA, potential complications of CSEA and neurological complications of CSA. Trend The intratheeal block is an ideal method for implementing labor analgesia. However, there is no an absolutely satisfied, safe, and simple method of labor analgesia, and relevant contents still need to be studied further.