浙江医学2023，Vol.45Issue(23)：2526-2530,5.DOI:10.12056/j.issn.1006-2785.2023.45.23.2022-3394
硬脊膜穿破硬膜外阻滞用于分娩镇痛的效果及对疼痛递质和应激反应指标的影响
Efficacy of dural puncture epidural block for labor analgesia and its effect on serum pain transmitter levels and stress state of parturients
摘要
Abstract
Objective To investigate the efficacy of dural puncture epidural(DPE)block on labor analgesia and its effect on pain transmitter level and stress state of parturients.Methods One hundred and twenty parturients receiving delivery analgesia in Lishui People's Hospital from February 2021 to June 2022 were randomly divided into two groups with 60 cases in each group.Parturients in the control group were given epidural labor analgesia,and those in the study group were given DPE analgesia.The contraction visual analogue scales(VAS)at different time points(before pain relief,30 min of pain relief,complete uterine opening,and delivery),the onset time and duration of analgesia,and the parturient delivery were documented and compared between two groups.The serum levels of prostaglandin E2(PGE2)and substance P(SP),norepinephrine(NE),cortisol(Cor),and adrenocortical hormone(ACTH)were measured before delivery and 24 h after delivery.Results There was no significant difference in contraction VAS scores before analgesia between two groups(P＞0.05);while VAS scores contraction at 30 min after analgesia,uterine opening and delivery in study group were lower than those in the control group(all P＜0.05).The onset time of analgesia in study group was significantly faster than that in the control group(P＜0.05);while there was no significant difference in the duration of analgesia between two groups(P＞0.05).The natural delivery rate,the first,second and third stage of labor were not significant different between two groups(all P＞0.05).The serum PGE2,SP,NE,Cor and ACTH levels 24 h after delivery were significantly higher than those before delivery in both groups(all P＜0.05);however,the levels in study were lower than those in the control group(all P＜0.05).Conclusion DPE is a good analgesic efficacy for labor analgesia,it can inhibit the release of pain transmitters with little effect on stress state in parturients.关键词
硬脊膜穿破硬膜外阻滞技术/产妇分娩镇痛/效果/疼痛递质/应激状态Key words
Dural puncture epidural block technique/Maternal labor analgesia/Effect/Pain transmitter/Stress state引用本文复制引用
游敏吉,翁晓华,代虹,吴继敏,刘志平..硬脊膜穿破硬膜外阻滞用于分娩镇痛的效果及对疼痛递质和应激反应指标的影响[J].浙江医学,2023,45(23):2526-2530,5.基金项目
浙江省医药卫生科技计划项目(2019ZH070、2022ZH023) （2019ZH070、2022ZH023）
浙江省医学会科研项目(2017ZYC-A131) （2017ZYC-A131）
