复方利多卡因乳膏在分娩镇痛穿刺点涂抹效果分析

目的评价复方利多卡因乳膏在分娩镇痛穿刺点涂抹的镇痛效果。方法采用前瞻性分析方法,选取2018年7月至2019年7月美中宜和妇儿医院行椎管内分娩镇痛的孕足月单活胎初产妇[美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级为Ⅰ或Ⅱ级]400例。采用随机数字表法随机分为两组(各200例),复方利多卡因乳膏局部涂抹组为A组,安慰剂涂抹组作为对照组(B组)。复方利多卡因乳膏及安慰剂在产妇分娩镇痛操作前15 min均匀涂抹于分娩镇痛穿刺点及周围。宫口开2 cm时行分娩镇痛,按照视觉模拟评分法(visual analogue scale,VAS)评估分娩镇痛操作时疼痛情况和分娩镇痛后72 h内腰背痛情况。结果A组有18例改行剖宫产,B组19例改行剖宫产,均剔除本研究。两组产妇麻醉操作时均无无痛和轻度疼痛发生。A组中度疼痛为100%(182/182),无重度疼痛例数;B组中度疼痛为27.07%(49/181),重度疼痛为72.93%(132/181);两组比较,A组疼痛程度明显减轻,差异有统计学意义(Z=208.575,P<0.001)。分娩镇痛后72 h内腰背痛发生情况无、轻度、中度、重度A组分别为136、27、15、4例,B组分别为89、54、27、11例,两组比较A组疼痛程度明显减轻,差异有统计学意义(Z=25.510,P<0.001)。结论复方利多卡因乳膏涂抹分娩镇痛穿刺点有助于减轻分娩镇痛操作时产生的穿刺痛和分娩镇痛后出现的腰背痛。

Analysis of the application effect of compound lidocaine cream on puncture point of labor analgesia

Objective A prospective study was carried out on 400 pregnant,full-term,single live primiparas with intraspinal delivery analgesia(American Society of Anesthesiologists(ASA)classⅠorⅡ).The patients were randomly divided into two groups by random number table method(200 cases in each group).The local application group of compound lidocaine cream was group A,and the placebo application group was the control group(group B).The compound lidocaine cream and placebo were evenly applied to the puncture point of labor analgesia 15 minutes before the operation of labor analgesia.According to the visual analog scale(VAS),the pain of labor analgesia operation and the lumbago within 72 hours after labor analgesia were evaluated.Results There were 18 cases in group A and 19 cases in group B changeding to underwent cesarean section.There was no painless or mild pain during anesthesia in both groups.In group A,moderate pain was 100%(182/182)and no severe pain was found.In group B,moderate pain was 27.07%(49/181)and severe pain was 72.93%(132/181).Compared Comparison between the two groups,the degree of pain in group A was significantly reduced(Z=208.575,P<0.001).The no,mild,moderate or severe lumbago and backache occurred 136,27,15 and 4 cases in group A and 89,54,27 and 11 cases in group B within 72 hours after labor analgesia,the difference was statistically significant(Z=25.510,P<0.001).Conclusion The application of compound lidocaine cream on the puncture point of labor analgesia is helpful to reduce the puncture pain during labor analgesia and the back pain after labor analgesia.