硬膜外持续给药和规律间断给药对足月初产妇分娩的影响

Influence of Epidural Continuous Administration and Regular Intermittent Administration on Labor of Full-term Primipara

目的:研究硬膜外持续给药和规律间断给药对足月初产妇分娩的影响。方法:选取2019年3月-2020年6月本院就诊的足月初产妇312例。按照随机数字表法分为对照组(n=156)和观察组(n=156)。对照组予以硬膜外持续给药方式进行麻醉,观察组予以硬膜外规律间断给药方式进行麻醉。观察两组分娩镇痛VAS评分、产程时间及破膜至分娩时间、麻醉药物用量及镇痛时间、不良反应发生情况。结果:麻醉后3 h、分娩时、分娩后1 h,两组VAS评分均低于干预前,观察组低于对照组(P<0.05);两组第一产程、第二产程、第三产程、破膜至分娩时间比较差异无统计学意义(P>0.05)。观察组罗哌卡因用量、芬太尼用量均少于对照组(P<0.05),两组镇痛时间比较差异无统计学意义(P>0.05)。观察组不良反应发生率(1.28%)低于对照组(6.41%),差异有统计学意义(P<0.05)。结论:硬膜外规律间断给药应用于足月初产妇麻醉效果更好,可减少麻醉药物的用量,从而降低不良反应发生,对产程及分娩时间、镇痛时间无显著影响,可临床推广。

Objective:To study the influence of epidural continuous administration and regular intermittent administration labor of full-term primipara.Method:A total of 312 full-term primipara who admitted to our hospital from March 2019 to June 2020 were selected and divided into the control group (n=156) and the observation group (n=156) according to random number table method.The control group was anesthetized by epidural continuous administration,while the observation group was anesthetized by epidural regular intermittent administration.The VAS score of labor analgesia,duration of labor,time from rupture of membranes to delivery,dosage of anesthetic drugs,analgesic time and occurrence of adverse reactions were observed in both groups.Result:At 3 h after anesthesia,during delivery and 1 h after delivery,the VAS scores in the two groups were lower than those before intervention,while those in the observation group were lower than those in the control group (P<0.05).There were no significant differences in the first stage of labor,the second stage of labor,the third stage of labor,time from rupture of membranes to delivery between the two groups (P>0.05).The dosage of Ropivacaine and Fentanyl in the observation group were less than those in the control group (P<0.05).There was no significant difference in analgesia time between the two groups (P>0.05).The incidence of adverse reactions in the observation group (1.28%) was lower than 6.41% in the control group,the difference was statistically significant (P<0.05).Conclusion:Epidural regular intermittent administration has better effect on anesthesia of full-term primipara,can reduce the dosage of anesthetic drugs,thus reducing the occurrence of adverse reactions,and has no influence on the course of labor,delivery time and analgesia time,which can be popularized clinically.