硬膜外麻醉在产科分娩镇痛中的临床效果探讨

The clinical effect of epidural anesthesia in obstetric labor analgesia

目的探讨硬膜外麻醉应用于产科分娩镇痛的临床效果。方法选取2018年2月至2019年2月本院收治的产科分娩镇痛患者100例,随机分为常规分娩组和硬膜外麻醉组,每组50例。常规分娩组采取常规分娩,硬膜外麻醉组采取硬膜外麻醉,分娩镇痛所用药物是先给予1%的利多卡因作为实验量,再持续泵入由0.1 mg芬太尼,15 mL 0.75%的罗派卡因与0.9%氯化钠溶液配置成100 mL的配置液,根据患者情况调节,以6~15 mL/h,自控3~10 mL/次,间隔15 min。比较两组自然分娩率,活跃期产程的平均时间、NRS评分、第二产程的平均时间、第三产程的平均时间、新生儿的Apgar评分(出生5 min),不同时间患者血流动力学指标和母婴并发症发生率。结果硬膜外麻醉组自然分娩率显著高于常规分娩组(P<0.05);硬膜外麻醉组活跃期产程的平均时间、NRS评分显著低于常规分娩组(P<0.05);两组第二产程的平均时间、第三产程的平均时间、新生儿的Apgar评分(出生5 min)比较差异无统计学意义;硬膜外麻醉组的血流动力学指标优于常规分娩组(P<0.05);硬膜外麻醉组母婴并发症发生率与常规分娩组比较差异无统计学意义。结论硬膜外麻醉应用于产科分娩镇痛效果良好,可有效维持血流动力学稳定,加速活跃期,并提高自然分娩率,对母婴无不良影响。

Objective To investigate the clinical effect of epidural anesthesia in obstetric labor analgesia.Methods 100 patients with obstetric labor analgesia in our hospital from February 2018 to February 2019 were selected,and they were randomly divided into routine delivery group and epidural anesthesia group,with 50 cases in each group.Routine delivery in routine delivery group,epidural anesthesia in epidural anesthesia group,with 1%lidocaine continue pumping by 0.1 mg fentanyl,0.75%of luo sent paid 15 mL and 0.9%sodium chloride configured to 100 mL the configuration of the fluid,according to patients condition adjustment,with 6-15 mL/h,3-10 mL/time,15 min intervals.Compare the rate of spontaneous delivery,mean time of active labor,NRS score,mean time of second labor,mean time of third labor,Apgar score of newborn(5 min after birth),hemodynamic parameters of patients at different time and incidence of maternal and infant complications between two groups.Results The rate of spontaneous delivery in the epidural anesthesia group was significantly higher than that in the routine delivery group(P<0.05).The mean time of active labor and NRS score in the epidural anesthesia group were significantly lower than those in the routine delivery group(P<0.05).There was no significant difference between the two groups in the mean time of the second birth,the mean time of the third birth and the Apgar score of the newborn(5 minutes after birth).The hemodynamic parameters of the epidural anesthesia group were better than those of the routine delivery group(P<0.05).There was no significant difference in the incidence of maternal and infant complications between the epidural anesthesia group and the routine delivery group.Conclusion Epidural anesthesia has good analgesic effect in obstetric delivery,can effectively maintain hemodynamic stability,accelerate the active period,and improve the rate of natural delivery.