腰-硬联合麻醉在无痛分娩中的应用效果

Application effect of combined lumbo-epidural anesthesia in painless delivery

目的研究腰-硬联合麻醉在无痛分娩中的应用效果。方法选取2021年1月至2022年12月景德镇市第二人民医院收治的100例无痛分娩的产妇作为研究对象。依据麻醉方案不同将其分成观察组(n=52)和对照组(n=48)。对照组接受硬膜外麻醉,观察组接受腰-硬联合麻醉。比较两组患者的麻醉起效时间、产程、疼痛程度、麻醉不良反应、妊娠结局及新生儿Apgar评分。结果观察组产妇的麻醉起效时间短于对照组,差异有统计学意义(P<0.05);观察组产妇的第一、第二产程短于对照组,差异有统计学意义(P<0.05);两组第三产程比较,差异无统计学意义(P>0.05);观察组产妇麻醉后5、30和60 min的疼痛评分低于对照组,差异有统计学意义(P<0.05);观察组产妇的麻醉相关不良反应发生率低于对照组,差异有统计学意义(P<0.05);观察组新生儿的出生后1 min Apgar评分高于对照组,差异有统计学意义(P<0.05)。结论无痛分娩中选择硬膜外麻醉与腰-硬联合麻醉均可实现镇痛效果,但腰-硬联合麻醉方案优势更为明显,主要体现在麻醉起效迅速,术中可获得良好镇痛效果,缩短产程,可提高麻醉安全性避免相关并发症的出现,具备临床推广价值。

Objective To study the application effect of combined lumbar-epidural anesthesia in painless delivery.Methods A total of 100 women with painless delivery admitted to the Second People's Hospital of Jingdezhen from January 2021 to December 2022 were selected as the study objects.They were divided into observation group(n=52)and control group(n=48)according to different anesthesia regimen.The control group received epidural anesthesia,and the observation group received lumbo-epidural anesthesia.The onset time of anesthesia effect,delivery duration,pain degree,anesthesia adverse reaction,pregnancy outcome and neonatal Apgar score were compared between the two groups.Results The onset time in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The duration of the first and second stages of delivery in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the duration of the third stage of delivery between the two groups(P>0.05).The pain scores 5,30 and 60 min after anesthesia in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of anesthesia related adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The Apgar score of neonates 1 min after birth in observation group was higher than that in control group,and the difference was statistically significant(P<0.05).Conclusion In painless delivery,epidural anesthesia and combined lumbo-epidural anesthesia can both achieve analgesic effects,but the combined lumbo-epidural anesthesia has more obvious advantages,mainly reflect in the rapid effect of anesthesia,good analgesic effect during the operation,shorten the delivery duration,improve the safety of anesthesia,avoid related complications,and have clinical promotion value.