不同椎管内镇痛方式在分娩镇痛中的效果比较

Comparison of the effects of different intraspinal analgesia methods in labor analgesia

目的:探讨低浓度罗哌卡因复合舒芬太尼连续硬膜外阻滞或腰硬联合阻滞镇痛分娩的效果。方法:选取244例行椎管内分娩镇痛的产妇,根据椎管内阻滞方法的不同分为硬膜外阻滞组(n=131)和腰硬联合阻滞组(n=113)。比较两组产程情况、产后出血量、新生儿Apgar评分和镇痛效果。结果:与硬膜外阻滞组相比,腰硬联合阻滞组各产程时间和总产程时间、麻醉起效时间、完善时间均较短(P<0.05);给药后5、10、15 min产妇VAS评分较低(P<0.05)。两组的分娩方式,产后出血量,新生儿1 min、5 min Apgar评分,麻醉药物药量,给药后30、60 min产妇VAS评分差异均无统计学意义(P>0.05)。结论:腰硬联合阻滞分娩镇痛在不增加剖宫产率及产后出血量、不影响母婴健康的基础上,产程更快,镇痛效果更好。

Objective:To investigate the effect of low concentrations of ropivacaine combined with sufentanil continuous epidural block or lumbar-epidural block for analgesic delivery.Methods:Two hundred and forty-four parturients undergoing intravertebral analgesia were divided into an epidural block group(n=131)and a lumbar-epidural block group(n=113).The labor stage,postpartum hemorrhage,neonatal Apgar score and analgesic effect were compared between the two groups.Results:The duration of labor,the total duration of labor,the onset of anesthetic effect and the improvement time were shorter and the maternal VAS scores at 5,10 and 15 min after administration were lower in the lumbar-epidural block group than the epidural block group(P<0.05).There were no significant differences between the two groups in delivery mode,postpartum bleeding volume,neonatal 1 min,5 min Apgar score,anesthetic drug volume,and maternal VAS score at 30,60 min after administration(P>0.05).Conclusion:The lumbar-hard combined block does not increase the cesarean section rate and postpartum hemorrhage and affect the health of the mother and baby,and its labor process is faster and the analgesic effect is better.