中国医药科学2025，Vol.15Issue(24)：94-97,121,5.DOI:10.20116/j.issn2095-0616.2025.24.19
阶梯多模式分娩镇痛的麻醉效果观察和对产妇及胎儿影响的研究
A study on the anesthetic efficacy of stepwise multi-modal labor analgesia and its effects on maternal and fetal outcomes
摘要
Abstract
Objective To investigate the anesthetic effect of ladder multi-modal labor analgesia and its impact on parturients and fetuses.Methods A retrospective study was conducted to analyze the clinical data of 150 primiparas who underwent labor analgesia and completed vaginal delivery in the Department of Obstetrics,Jiangsu Shengze Hospital Affiliated to Nanjing Medical University,from January 2023 to December 2024.The parturients were divided into two groups according to the labor analgesia methods:traditional epidural labor analgesia group(group C,75 cases)and ladder multi-modal labor analgesia group(group D,75 cases).The duration of the first,second,and third stages of labor was recorded.Visual analogue scale(VAS)scores for pain were documented at the following time points:upon admission to the labor room,before epidural analgesia,30 minutes after epidural analgesia,at full cervical dilation,during fetal delivery,and during placental delivery.The number of cases in group D requiring additional remifentanil intravenous micro-pump analgesia was counted.Neonatal 1-minute and 5-minute Apgar scores,incidence of adverse reactions(hypotension,nausea,vomiting,etc.)in parturients,and satisfaction scores were recorded.Results There was no significant difference in the duration of each labor stage between the two groups(P>0.05).Compared with group C,group D showed significantly lower VAS scores before epidural analgesia,at full cervical dilation,and during fetal delivery(P<0.05).Twelve cases(16.0%)in group D required additional remifentanil analgesia.No significant differences were observed between the two groups in neonatal 1-minute and 5-minute Apgar scores or the incidence of maternal adverse reactions(P>0.05).The satisfaction score of group D was significantly higher than that of group C(P<0.05).Conclusion The ladder multi-modal labor analgesia protocol demonstrates definite analgesic efficacy,better meets the analgesic needs of parturients,exerts no adverse effects on parturients and fetuses,and achieves high maternal satisfaction,indicating its clinical application value.关键词
多模式/分娩镇痛/导乐分娩/硬膜外/静脉/瑞芬太尼Key words
Multi-modal/Labor analgesia/Doula delivery/Epidural/Intravenous/Remifentanil分类
医药卫生引用本文复制引用
徐一刚,范建萍,吴涛,姚沈婷,梅芳..阶梯多模式分娩镇痛的麻醉效果观察和对产妇及胎儿影响的研究[J].中国医药科学,2025,15(24):94-97,121,5.基金项目
南京医科大学附属江苏盛泽医院课题(YYKY202309). （YYKY202309）
