BACKGROUND The background of this study was analgesia in natural delivery.The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor,and combined spinal-epidural anesthesi...BACKGROUND The background of this study was analgesia in natural delivery.The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor,and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases.AIM To study the effects of combined spinal-epidural anesthesia on anxiety,labor analgesia,and motor blocks in parturients during natural delivery.METHODS A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included;a random number table approach was employed to divide the women into a control group and a joint group,with each group consisting of 60 women.The control group was given epidural anesthesia,while the joint group was given combined spinal-epidural anesthesia.The visual analog scale(VAS)was used to evaluate the degree of maternal pain.Comparisons were made between the two groups’conditions of childbirth and the duration of labor.Apgar scores were used to evaluate the status of the newborns at birth;Self-rating Anxiety Scale(SAS)and General Self-Efficacy Scale(GSES)scores,umbilical artery blood gas analysis indices and stress indices were compared between the two groups;and the frequencies of motor block and postpartum complications were analyzed.RESULTS In comparison to the control group,in the joint group,the VAS scores for the first,second,and third stages of labor were lower(P<0.05).The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group(P<0.05).No significant differences were observed in the Apgar score,the duration of the first stage of labor,or the total duration of labor between the two groups(P>0.05).The second and third stages of labor in the joint group were shorter than those in the control group(P<0.05).When compared to the control group,the postpartum SAS score of the joint group was lower,while the GSES score was greater(P<0.05).Between the control group and the joint group,the differences observed in pH,arterial carbon dioxide partial pressure,arterial oxygen partial pressure,or arterial hydrogen ion concentration were not significant(P>0.05).Nitric oxide,cortisol,and adrenaline levels were lower in the joint group than in the control group(P<0.05).There were no substantial differences in Bromage grade or rate of complications between the two groups(P>0.05).CONCLUSION For parturients during natural delivery,combined spinal-epidural anesthesia can reduce anxiety,provide labor analgesia,shorten labor time,and reduce postoperative stress levels but did not result in a motor block.展开更多
目的探讨分娩镇痛中采用椎管神经阻滞麻醉的效果及对分娩结局的影响。方法120例分娩产妇,按双盲法分为对照组和观察组,每组60例。对照组给予常规分娩干预,观察组给予椎管神经阻滞麻醉镇痛。比较两组疼痛程度、分娩结局、临床指标。结果...目的探讨分娩镇痛中采用椎管神经阻滞麻醉的效果及对分娩结局的影响。方法120例分娩产妇,按双盲法分为对照组和观察组,每组60例。对照组给予常规分娩干预,观察组给予椎管神经阻滞麻醉镇痛。比较两组疼痛程度、分娩结局、临床指标。结果观察组产妇视觉模拟评分法(VAS)评分为(4.61±1.14)分,低于对照组的(7.08±1.24)分,差异具有统计学意义(P<0.05)。观察组产妇阴道分娩率88.33%高于对照组的66.67%,产后出血率3.33%、新生儿窒息率0低于对照组的13.33%、6.67%,差异具有统计学意义(P<0.05)。观察组阴道分娩产妇第一产程时间(8.22±1.75)h、第二产程时间(1.02±0.26)h均短于对照组阴道分娩产妇的(9.84±2.52)、(1.38±0.21)h,差异具有统计学意义(P<0.05)。观察组新生儿出生后1、5 min Apgar评分高于对照组,出血量少于对照组,差异具有统计学意义(P<0.05);两组心率、胎心率比较差异无统计学意义(P>0.05)。结论椎管神经阻滞麻醉在产妇分娩镇痛中应用可行性较高,可改善其疼痛程度及分娩结局,缩短产程,提高新生儿Apgar评分,值得借鉴及参考。展开更多
基金Changning District Health Commission Medical Key(Characteristic)Specialized Program,No.20192003.
文摘BACKGROUND The background of this study was analgesia in natural delivery.The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor,and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases.AIM To study the effects of combined spinal-epidural anesthesia on anxiety,labor analgesia,and motor blocks in parturients during natural delivery.METHODS A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included;a random number table approach was employed to divide the women into a control group and a joint group,with each group consisting of 60 women.The control group was given epidural anesthesia,while the joint group was given combined spinal-epidural anesthesia.The visual analog scale(VAS)was used to evaluate the degree of maternal pain.Comparisons were made between the two groups’conditions of childbirth and the duration of labor.Apgar scores were used to evaluate the status of the newborns at birth;Self-rating Anxiety Scale(SAS)and General Self-Efficacy Scale(GSES)scores,umbilical artery blood gas analysis indices and stress indices were compared between the two groups;and the frequencies of motor block and postpartum complications were analyzed.RESULTS In comparison to the control group,in the joint group,the VAS scores for the first,second,and third stages of labor were lower(P<0.05).The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group(P<0.05).No significant differences were observed in the Apgar score,the duration of the first stage of labor,or the total duration of labor between the two groups(P>0.05).The second and third stages of labor in the joint group were shorter than those in the control group(P<0.05).When compared to the control group,the postpartum SAS score of the joint group was lower,while the GSES score was greater(P<0.05).Between the control group and the joint group,the differences observed in pH,arterial carbon dioxide partial pressure,arterial oxygen partial pressure,or arterial hydrogen ion concentration were not significant(P>0.05).Nitric oxide,cortisol,and adrenaline levels were lower in the joint group than in the control group(P<0.05).There were no substantial differences in Bromage grade or rate of complications between the two groups(P>0.05).CONCLUSION For parturients during natural delivery,combined spinal-epidural anesthesia can reduce anxiety,provide labor analgesia,shorten labor time,and reduce postoperative stress levels but did not result in a motor block.
文摘目的探讨分娩镇痛中采用椎管神经阻滞麻醉的效果及对分娩结局的影响。方法120例分娩产妇,按双盲法分为对照组和观察组,每组60例。对照组给予常规分娩干预,观察组给予椎管神经阻滞麻醉镇痛。比较两组疼痛程度、分娩结局、临床指标。结果观察组产妇视觉模拟评分法(VAS)评分为(4.61±1.14)分,低于对照组的(7.08±1.24)分,差异具有统计学意义(P<0.05)。观察组产妇阴道分娩率88.33%高于对照组的66.67%,产后出血率3.33%、新生儿窒息率0低于对照组的13.33%、6.67%,差异具有统计学意义(P<0.05)。观察组阴道分娩产妇第一产程时间(8.22±1.75)h、第二产程时间(1.02±0.26)h均短于对照组阴道分娩产妇的(9.84±2.52)、(1.38±0.21)h,差异具有统计学意义(P<0.05)。观察组新生儿出生后1、5 min Apgar评分高于对照组,出血量少于对照组,差异具有统计学意义(P<0.05);两组心率、胎心率比较差异无统计学意义(P>0.05)。结论椎管神经阻滞麻醉在产妇分娩镇痛中应用可行性较高,可改善其疼痛程度及分娩结局,缩短产程,提高新生儿Apgar评分,值得借鉴及参考。
