电子脉冲泵间歇性硬膜外注射与机械泵持续性硬膜外注射对分娩镇痛中麻醉药物使用剂量、会阴镇痛及分娩结局的影响比较

Comparison of the effects of intermittent epidural injection with electronic pulse pump and continuous epidural injection with mechanical pump on the dosage of anesthetic drugs,perineal analgesia and delivery outcome in labor analgesia

目的 比较电子脉冲泵间歇性硬膜外注射与机械泵持续性硬膜外注射在分娩镇痛中的应用效果。方法选取2019年8月至2021年8月在我院行分娩镇痛的100例产妇作为研究对象,以镇痛方式不同将其分为A组和B组,各50例。A组采用电子脉冲泵间歇性硬膜外注射,B组采用机械泵持续性硬膜外注射。比较两组的麻醉效果。结果 A组的罗哌卡因、舒芬太尼用量及宫口全开前30 min、宫口全开时、分娩时的视觉模拟评分法(VAS)评分均低于B组(P<0.05)。宫口全开前30 min、宫口全开时、分娩时,A组的皮质醇(Cor)、肾上腺素(E)水平均低于B组(P<0.05)。A组的自然分娩率高于B组,会阴侧切率低于B组(P<0.05)。两组的新生儿出生后1、5 min Apgar评分、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、pH比较,差异无统计学意义(P>0.05)。结论 电子脉冲泵间歇性硬膜外注射较机械泵持续性硬膜外注射在产妇分娩镇痛中更具优势,其能减少麻醉药物使用剂量,提高镇痛效果及自然分娩率,降低会阴侧切率。

Objective To compare the application effect of intermittent epidural injection with electronic pulse pump and continuous epidural injection with mechanical pump in labor analgesia.Methods A total of 100 parturients who underwent labor analgesia in our hospital from August 2019 to August 2021 were selected as the research objects.The parturients were divided into group A and group B according to different analgesia methods,with 50 cases in each group.The group A received intermittent epidural injection with electronic pulse pump,and the group B received continuous epidural injection with mechanical pump.The anesthetic effects of the two groups were compared.Results The dosage of ropivacaine and sufentanil,and the Visual Analogue Scale(VAS)score at 30 min before uterine opening,when uterine opening and delivery in the group A were lower than those in the group B(P<0.05).At 30 min before uterine opening,when uterine opening and delivery,the levels of cortisol(Cor)and epinephrine(E)in the group A were lower than those in the group B(P<0.05).The natural delivery rate of the group A was higher than that of the group B,and the episiotomy rate was lower than that of the group B(P<0.05).There were no significant differences in neonatal Apgar score after birth 1 and 5 min after birth,arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))and pH between the two groups(P>0.05).Conclusion Intermittent epidural injection with electronic pulse pump has more advantages than continuous epidural injection with mechanical pump in parturients labor analgesia,it can reduce the dosage of anesthetic drugs,improve the analgesic effect and natural delivery rate,and reduce the rate of episiotomy.