笑气吸入用于分娩镇痛的有效性与安全性研究

目的　探讨笑气吸入分娩镇痛的有效性与安全性。方法　将 130 0例单胎头位、足月初产妇分为两组。其中 ,研究组 6 5 8例 ,在产程中吸入 5 0 %笑气与 5 0 %氧气的混合气体实行分娩镇痛 ;对照组 6 4 2例 ,产程中间断吸入氧气。观察两组产妇疼痛的缓解程度、产程时间、分娩方式、羊水情况、分娩失血量、新生儿出生时的Apgar评分、产妇桡动脉与新生儿脐动脉血气分析的结果、笑气吸入的副反应。结果　研究组产妇分娩镇痛的有效率为 80 9% ,总产程时间为 4 6 8min ,活跃期时间为 15 3min ,剖宫产率为 11 6 % ,羊水污染率 2 2 0 % ,新生儿窒息率 1 2 % ,产时出血平均 2 37ml,39 4 %的产妇出现头晕表现的副反应 ;而对照组产妇分娩镇痛的有效率为 0 9% ,活跃期时间为 187min ,剖宫产率为 19 3% ,与研究组比较 ,差异有显著性 (P <0 0 5 ) ;而产程时间 4 80min ,羊水污染率 2 4 3% ,新生儿窒息率 1 7% ,产时出血平均 2 5 3ml,与研究组比较 ,差异无显著性 (P >0 0 5 ) ;对照组产妇无明显的头晕等副反应。两组产妇桡动脉及脐动脉血气分析结果比较 ,差异无显著性 (P >0 0 5 )。结论　 5 0 %笑气与 5 0 %氧气的混合气体用于分娩镇痛安全方便 ,易被产妇接受 ,可有效地缓解分娩疼痛 ,增加阴道分娩率 ,对产程及母儿

Clinical study on efficacy and safety of labor analgesia with inhalation of nitrous oxide in oxygen

Objective To investigate the efficacy and safety of labor analgesia with inhalation of 50% nitrous oxide in oxygen. Methods A total of 1300 cases of term primiparous women in labor were divided into two groups. Study group ( n =658) 50% nitrous oxide in oxygen was inhalated during labor for relieving labor pain. Control group ( n =642) intermittent inhalation of 50% oxygen was carried out during labor. Two groups were compared with following indices: duration of the labor, delivery mode, meconium stained of amniotic fluid, postpartum bleeding volume, neonatal Apgar score, side effect of nitrous oxide, and blood gas analysis of samples from maternal radius artery and fetal umbilical blood. Results The efficiency of relieving labor pain in study group was much better than that of control group (80.9% vs 0.9%, P <0.001). Rate of cesarean section in study group was lower than control group (11.6% vs 19.3%, P <0.05). The active phase of labor in study group was shorter than control group (153 min vs 187 min, P <0.05). There was side effect of dizziness in 39.4% cases of study group but there were no any complaint in the control group cases. There were no significantly differences in duration of the labor, meconium stained amniotic fluid, postpartum bleeding volume, neonetal Apgar score, and blood gas analysis between two groups ( P >0.05). Conclusion Inhalation of 50% nitrous oxide in oxygen was safe and effective labor analgesia. It is acceptable. The measure of relieving labor pain may increase the vaginal birth rate. There is no sevese side effect on mothen and baby.