超声引导下竖脊肌平面阻滞麻醉与硬膜外麻醉用于无痛分娩的效果和安全性比较

Comparison of the Efficacy and Safety of Ultrasus-Guided Erector Spinal Muscle Plane Block Anesthesia and Epidural Anesthesia for Painless Delivery

目的:比较无痛分娩镇痛中超声引导下竖脊肌平面阻滞麻醉(ESPB)与硬膜外麻醉的效果及安全性。方法:回顾性选取2022年6月至2023年6月入院的80例产妇,参考麻醉方式的不同分为A组(ESPB,40例)与B组(硬膜外麻醉,40例);比较两组产妇的第一产程、第二产程,新生儿Apgar评分(出生时、出生后5min),产妇不良反应(头痛、恶心呕吐、瘙痒、发热)与镇痛前、分娩完成时数字评定量表(NRS)评分。结果:产程:A、B组产妇第一产程比较,差异无统计学意义(P>0.05);A组第二产程短于B组,差异有统计学意义(P<0.05)。Apgar评分:A、B组新生儿出生时、出生后5min Apgar评分比较,差异无统计学意义(P>0.05)。不良反应:A、B组产妇不良反应总发生率比较,差异无统计学意义(P>0.05)。NRS评分:镇痛前,两组产妇NRS评分比较,差异无统计学意义(P>0.05);分娩完成时,两组产妇的NRS评分均明显低于镇痛前,差异有统计学意义(P<0.05);A组分娩完成时的NRS评分均低于B组,差异有统计学意义(P<0.05)。结论:无痛分娩镇痛中超声引导下ESPB麻醉与硬膜外麻醉均具有良好效果,安全性高,且超声引导下ESPB麻醉可进一步缩短产妇第二产程时间,止痛效果更佳。

Objective:To compare the effect and safety of ultrasound-guided erector spinal muscle plane block anesthesia(ESPB)with epidural anesthesia during painless labor analgesia.Methods:Retrospectively,80 women admitted from June 2022 to June 2023 were divided into group B(epidural anesthesia,40);comparing the first stage and second stage,neonatal Apgar score(at birth and 5 min),maternal adverse reactions(headache,nausea,vomiting,pruritus,fever),and numerical rating scale(NRS)score in different periods(30 min before analgesia,10 cm at cervical dilatation,and at delivery).Results:Stage of labor:comparing the first stage of labor in groups A and B,the difference was not significant(P>0.05);the second stage of labor in group A was shorter than group B,and the difference was significant(P<0.05).Apgar score:Groups A and B at 5 min Apgar,the difference was not significant(P>0.05).Adverse reactions:comparing the incidence of headache,nausea,vomiting,itching,and fever in groups A and B,the difference was not significant(P>0.05).NRS score:comparing the NRS score before analgesia,the difference between the two groups was not significant(P>0.05);the NRS score of 30 min analgesia,10 cm cervical dilation was significantly lower than the difference(P<0.05);the NRS score at 30 min analgesia and 10 cm cervical dilation was lower than group B,and the difference was significant(P<0.05).Conclusion:In painless labor and analgesia,both ultrasus-guided ESPB anesthesia and epidural anesthesia have good effects and high safety,and ultrasus-guided ESPB anesthesia can further shorten the second stage of labor and have better analgesic effect.