不同硬膜外给药速率对分娩镇痛的影响

Effect of Different Epidural Drug Delivery Rates on Labor Analgesia

目的:分析不同硬膜外给药速率对分娩镇痛的影响。方法:选取2020年1月-2022年1月广州市第一人民医院和广州妇女儿童医疗中心收治的自然分娩产妇83例为观察对象,均给予程控硬膜外脉冲式注射(PIEB)镇痛,根据给药速率不同分为研究1组(n=22)、研究2组(n=33)、研究3组(n=28),研究1组维持100 mL/h给药速率,研究2组维持200 mL/h给药速率,研究3组维持300 mL/h给药速率。比较三组视觉模拟评分法(VAS)评分、运动阻滞评分(Bromage)、Blouse次数、罗哌卡因用量、产程、不良反应发生率、胎儿Apgar评分、产妇满意度。结果:镇痛后30 min、宫开<6指、宫开6~9指、宫开>9指、娩出胎儿时,三组VAS评分、Bromage评分比较,差异无统计学意义(P>0.05);研究3组Blouse次数低于研究1组、研究2组,研究3组罗哌卡因用量高于研究1组、研究2组,差异有统计学意义(P<0.05);三组第一、第二、第三及总产程、胎儿Apgar评分、产妇不良反应发生率、产妇满意度比较,差异无统计学意义(P>0.05)。结论:分娩镇痛中程控硬膜外脉冲式注射不同注药速率对产妇分娩疼痛感、产程、罗哌卡因用量、Blouse次数、不良反应发生率、产妇满意度、新生儿健康状况影响较小,医生可根据产妇实际情况调节注射速率。

Objective:To analyze the effect of different epidural drug delivery rates on labor analgesia.Methods:Eighty-three cases of natural childbirth admitted to the Guangzhou First People's Hospital and Guangzhou Women and Children Medical Center from January 2020 to January 2022 were selected as observation subjects,and all of them were given program-controlled epidural pulsatile injection(PIEB)analgesia.The study groups were divided into study group 1(n=22),study group 2(n=33)and study group 3(n=28)according to the administration rate,and the administration rate of 100 mL/h was maintained in study group 1,200 mL/h in study group 2 and 300 mL/h in study group 3.The visual analogue scoring(VAS)score,motor block score(Bromage),Blouse count,ropivacaine dosage,length of labor,incidence of adverse events,fetal Apgar score,and maternal satisfaction were compared among the three groups.Results:There were no statistically significant differences in VAS score and Bromage score when comparing the three groups at 30 min after analgesia,at opening<6 fingers,at opening 6-9 fingers,at opening>9 fingers,and at delivery of the fetus(P>0.05).The number of Blouse was lower in study group 3 than in study group 1 and study group 2,and the amount of ropivacaine was higher in study group 3 than in study group 1 and study group 2,and the difference was statistically significant(P<0.05).The differences were not statistically significant(P>0.05)when comparing the first,second,third and total length of labor,fetal Apgar score,incidence of maternal adverse effects,and maternal satisfaction in the three groups.Conclusion:The different injection rates of program-controlled epidural pulsatile injection in labor analgesia have little effect on labor pain,labor duration,ropivacaine dosage,Blouse number,incidence of adverse effects,maternal satisfaction,and neonatal health status,and the doctor can adjust the injection rate according to the actual situation of women.