陕西医学杂志2016，Vol.45Issue(6)：669-672,4.DOI:10.3969/j.issn.1000-7377.2016.06.011
腰麻联合自控硬膜外阻滞分娩镇痛对产程及分娩方式的影响
The effects of combined spinal anesthesia and patient controlled epidural analgesia on labor process and delivery modes
李友安 1冶省娟 1李学敏 1陈智慧 1孙毅 1白淑娟1
作者信息
摘要
Abstract
Objective :To observe effect of combined spinal anesthesia and patient controlled epidural anal‐gesia on labor process and Delivery Modes ,and evaluate the safety and feasibility .Methods :240 nulliparous women with term singleton without the contraindication of epidural block were divided into the experimental group (Z) and the control group (D) .Full‐term nulliparous women in D group were given routine nursing and accepted vaginal de‐livery .without any analgesia for labor .On the basis of D group ,primipara in Z group were given combined spinal and epidural anesthesia (CSEA)when their cervical dilation reached 2 cm .Followed by insertion of a 25‐G spinal nee‐dle into the subarachnoid space through the epidural needle .And slowly injecting o ropivacaine 3mg ,then implanted the epidural catheters in the the headl space .The primiparaes began to accept continuous epidural infusion at 30min , the administrative mode by PCEA was used for analgesia .A mixture of 0 .1% ropivacaine combined with 0 .5mg/L sufentanil was put into the electric pump .The background infusion volume was6 ~ 8 ml/h ,and the PCA volume was 5 ml ,the lock‐time was 30 minutes .The VAS scores during different time points of the second and after labor anal‐gesia before and after labor analgesia were collected .The time of vaginal delivery ,delivery mode ,the volume of Oxy‐tocin ,the fetal Apgar scores of 1 and 5 minutes ,the side effects of analgesia ,amount of bleeding during vaginal deliv‐ery was collected .Results :The VAS score of nulliparous women in Z group was significantly lower than that in D group(P< 0 .05) .The time of first stage of labor was signifcantiy shortened ,as well as reduced the cesarean rate (P< 0 .05) .The use dosage of Oxytocin of Z goup was markedly higher than D group(P< 0 .05) .There was no significant difference in other indicators (P > 0 .05) .Conclusion :The PCEA is an effective and quick way in pain relieve during vaginal deliver ,and it did not appear to be harmful to maternal and infants ,also shortened the first stage of labor as well as reduced the cesarean rate ,which is worth popularizing .关键词
分娩 ,产科/镇痛 ,产科/镇痛 ,硬膜外/麻醉药 ,联用分类
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李友安,冶省娟,李学敏,陈智慧,孙毅,白淑娟..腰麻联合自控硬膜外阻滞分娩镇痛对产程及分娩方式的影响[J].陕西医学杂志,2016,45(6):669-672,4.
