分娩镇痛中钢丝加强型硬膜外导管给予程控硬膜外脉冲注射镇痛效果

Effect of programmed epidural pulse injection with steel wire reinforced epidural catheterin used in labor analgesia

目的:分析分娩镇痛中钢丝加强型硬膜外导管给予程控硬膜外脉冲注射镇痛效果。方法:选取2020年9月-2022年8月本院收治的有分娩镇痛需求的初产妇157例,根据镇痛方式随机分为3组,A组通过钢丝加强型硬膜外导管给予常规持续硬膜外输注镇痛,B组通过普通塑料硬膜外导管给予程控硬膜外脉冲注射镇痛,C组通过钢丝加强型硬膜外导管给予程控硬膜外脉冲注射镇痛。记录3组给药后各时点镇痛效果、镇痛药物使用、满意度、新生儿Apgar评分、脐血血气分析、镇痛及置管不良反应发生情况。结果:A组、B组、C组镇痛前及镇痛后1h视觉模拟评分法(VAS)评分无差异(P>0.05),镇痛后2h、3h、4h及宫口全开时VAS评分依次降低;舒芬太尼(32.50±8.41μg、28.73±7.74μg、26.25±6.72μg)、罗哌卡因(65.67±18.28 mg、60.68±19.32 mg、55.36±15.45 mg)使用剂量依次降低,满意度评估(5.63±1.46分、7.48±1.13分、9.10±0.53分)依次升高(均P<0.05);3组新生儿Apgar评分及脐血血气分析无差异,镇痛后总不良反应发生无差异(P>0.05);置管不良反应发生A组(53.7%)、B组(11.5%)、C组(7.8%)依次降低(P<0.05)。结论:钢丝加强型硬膜外导管给予程控硬膜外脉冲注射用于分娩镇痛效果显著,可减少麻醉药物使用,降低置管相关不良事件发生。

Objective:To analyze the effect of programmed epidural pulse injection with steel wire reinforced epidural catheter used in labor analgesia.Methods:157primiparas with needs of analgesic effect were selected and were divided into three groups according to the mode of analgesia from September 2020to August 2022.The primiparas in group A were given routine routine continuous epidural infusion analgesia with a steel wire reinforced epidural catheter,the primiparas in group B were given programmed epidural pulse injection analgesia with an ordinary plastic epidural catheter,and the primiparas in group C were given programmed epidural pulse injection analgesia with a steel wire reinforced epidural catheter.The analgesic effect,the dosage of analgesics,the satisfaction,the Apgar score and umbilical blood gas analysis of the newborn,the adverse reaction rate of analgesia and catheterization of the primiparas in the three groups at different time point were recorded.Results:There was no significant difference in visual analogue scale(VAS)score of the primiparas before analgesia and at 1hafter analgesia among the three groups(P>0.05).The VAS score of the primiparas in the three groups at 2h,3h,4hafter analgesia,and at the time of cervical dilation had decreased gradually.The doses of sufentanil of the primiparas in group A,in group B,and in group C(32.50±8.41μg,28.73±7.74μg,and 26.25±6.72μg)and the doses of ropivacaine of the primiparas in group A,in group B,and in group C(65.67±18.28mg,60.68±19.32mg,and 55.36±15.45mg)had decreased gradually.The satisfaction evaluation scores of the primiparas in group A,in group B,and in group C(5.63±1.46,7.48±1.13,and 9.10±0.53)had increased gradually(all P<0.05).There were no significant differences in the neonatal Apgar score,the values of the cord blood gas analysis,and the total adverse reactions rate after analgesia of the primiparas among the three groups(P>0.05).The incidence of adverse reactions of the primiparas in group A(53.7%),in group B(11.5%),and in group C(7.8%)had decreased gradually(P<0.05).Conclusion:Programmed epidural pulse injection with steel wire reinforced epidural catheter used in labor analgesia has significant analgesic effect,which can reduce the dosage of anesthetic and the incidence of adverse events related to catheterization.