阴部神经阻滞在第二产程中的应用及对产妇分娩的影响

The Application of Pudendal Nerve Block in the Second Stage of Labor and Its Effect on Puerperant Delivery

目的:探讨采用阴部神经阻滞与椎管内镇痛对产妇分娩第二产程的影响。方法:本研究将南昌市第一医院2022年1月—2023年11月收治的108例产妇作为研究对象,将其随机分为观察组58例,对照组50例,对照组采用椎管内镇痛,观察组采用阴部神经阻滞。比较两组分娩情况、疼痛评分、新生儿情况、满意度。结果:两组中转剖宫产数、阴道裂伤数比较,差异均无统计学意义(P>0.05)。观察组阴道侧切数、缩宫素使用数、产钳助产数均比对照组少,差异均有统计学意义(P<0.05)。两组第一产程视觉模拟评分法(VAS)评分比较,差异无统计学意义(P>0.05);观察组第二产程VAS评分比对照组低,差异有统计学意义(P<0.05)。两组新生儿心率、Apgar评分比较,差异均无统计学意义(P>0.05)。观察组满意度评分比对照组高,差异有统计学意义(P<0.05)。结论:在第二产程中采用阴部神经阻滞具有减少会阴侧切、缩宫素使用、产钳助产的作用,并且能够在第二产程中减少产妇疼痛,对新生儿无影响,具有明显的镇痛优势,能够被产妇所接受。

Objective:To investigate the effect of using pudendal nerve block and intraspinal analgesia on second stage of labor of puerperant delivery.Method:In this study,108 cases of puerperant admitted to the First Hospital of Nanchang from January 2022 to November 2023 were taken as research subjects,and they were randomly divided into 58 cases in the observation group and 50 cases in the control group.The control group used intrathecal analgesia,and the observation group used pudendal nerve block.The delivery situation,pain scores,neonatal situation,and satisfaction level in two groups were compared.Result:There were no statistically significant differences in the number of cesarean sections and vaginal lacerations between the two groups(P>0.05).The number of vaginal lateral incisions,the use of oxytocin,and the number of delivery forceps in the observation group were all lower than those in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the visual analogue scale(VAS)scores of the first stage of labor between the two groups(P>0.05);the VAS score of the second stage of labor in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).There were no statistically significant differences in neonatal heart rate and Apgar scores between the two groups(P>0.05).The satisfaction score of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion:The use of pudendal nerve block in the second stage of labour has the effect of reducing vaginal lateral incisions,the use of oxytocin,forceps-assisted delivery,and is able to reduce puerperant pain in the second stage of labour,with no effect on neonates,and has obvious analgesic advantages,which can be accepted by puerperant.