硬膜外麻醉和腰硬联合阻滞在84例待产妇分娩镇痛中的临床对比研究

Effect of epidural anesthesia and combined spinal-epidural anesthesia on labor analgesia for 84 primiparas

目的:比较硬膜外麻醉和腰硬联合阻滞在待产妇分娩镇痛中的临床效果。方法:选择168例在我院生产的健康、单胎、足月临产初产妇,按麻醉方式分为硬膜外麻醉组(EA组)和腰硬联合阻滞组(CSE组),每组各84例。比较不同时间点产妇VAS疼痛评分、镇痛起效及维持时间、下肢运动阻滞评分及第一、二、三产程时间、新生儿1min和5min Apgar评分、产妇不良反应情况等。结果:CSE组镇痛起效时间为(2.74±1.48)min,显著短于EA组(P<0.05),而镇痛维持时间达到(114.56±22.74)min,显著长于EA组(P<0.05);两组产妇第一、二和三产程时间、下肢运动阻滞评分、新生儿1min和5min Apgar评分差异统计学意义(P>0.05);CSE组总不良反应率为9.52%,显著低于EA组(P<0.05)。结论:硬膜外麻醉和腰硬联合阻滞对待产妇分娩均具有良好的镇痛效果,腰硬联合阻滞镇痛起效更快、持续时间更长,对产妇及新生儿无明显副作用,综合疗效确切。

Objective：To investigate the clinical effect of epidural anesthesia and combined spinalepidural anesthesia on the labor analgesia for primiparas.Methods：A total of 168healthy primiparas,who had single birth and full term were divided into epidural anesthesia group（EA group）and combined spinalepidural anesthesia group（CSE group）by half.VAS pain score at different time points,the onset and duration time of analgesic,the score of motor block in lower linbs,Apgar score of neonatal at 1min and 5 min after delivery and adverse reactions were observed and compared.Results：The onset time of analgesic in the CSE group was（2.74±1.48）min,which was significantly shorter than that in the EA group（P 0.05）;while the duration time of analgesia in the CSE group reached（114.56±22.74）min,which was significantly longer than that in the EA group（P0.05）.There was no significant difference in the time of birth process,the score of motor block,Apgar score at 1min and 5min between the two groups（P 0.05）.Total adverse reaction rate was 9.52%,significantly lower than that in the EA group（P0.05）.Conclusions：Epidural anesthesia and combined spinal-epidural anesthesia are effective on labor analgesia for primiparas.Combined spinal-epidural analgesia is faster and longer,and it is of fewer adverse reaction,the comprehensive effect is more satisfactory.