双侧阴部神经阻滞麻醉在产程中的应用

目的探讨双侧阴部神经阻滞麻醉在产程中的临床应用和效果。方法随机选择113例无锡市妇幼保健医院经阴道分娩的足月初产妇,分成2组,观察组56例行双侧阴部神经阻滞麻醉;对照组57例行单侧阴部神经阻滞麻醉。观察2组会阴切开方式、伤口出血量、伤口疼痛、伤口愈合、产妇的依从性和产妇平均住院时间情况。结果观察组会阴侧切率及切口出血量>20 mL者低于对照组(P<0.05,P<0.01),会阴正中切开率及切口出血量<20 mL者高于对照组(P<0.05,P<0.01);观察组镇痛效果及产妇依从率优于对照组(P<0.05),产妇会阴切口甲级愈合率与对照组比较差异无统计学意义(P>0.05);平均住院时间短于对照组(P<0.05)。结论双侧阴部神经阻滞麻醉,降低了会阴侧切率,减少了会阴切口的出血量,减轻了产妇会阴切口的疼痛,提高了会阴切口的甲级愈合率,同时产妇的依从性好,缩短了住院时间,值得临床推广。

Application of bilateral pudendal nerve block anesthes during birth process

Objective To investigate the effect of bilateral pudendal nerve block anesthesia during birth process. Methods 113 cases who were performed with bilateral pudendal nerve block anesthesia were selected and divided into two groups randomly. Patients in observation group（n = 56） were given bilateral pudendal nerve block anesthesia. Patients in control group（ n = 57 ） were given unilateral pudendal nerve block anesthesia. The way of perineal cut, amount of bleeding, ache degree of wound, the level of wound healing, compliance of puerpera and average stay were compared between two groups. Results The rate of episiotomy and the number of patients whose amount of bleeding 〉 20 mL in observation group were lower than those in control group（P 〈0.05 ,P 〈 0.01 ）,the rate of midsection and the number of patients whose amount of bleeding 〈 20 mL in observation group were higher than those in control group （ P 〈 0.05, P 〈 0.01 ）. The effect of analgesia and compliance of puerpera in observation group were better than those in control group （ P 〈 0.05 ）. There was no statistically significant in the Class-A healing rate of pudendal incision between two groups（ P 〉 0.05 ）. The average stay in observation was lower than that in control group（P 〈 0.05）. Conclusion Bilateral pudendal nerve block anesthesia can reduce the rate of episiotomy,the amount of bleeding and the degree of ache, and can improve the Class-A healing rate of incision. Meanwhile the compliance of puerpera is good, and the average stay is shortened. It is worthy to be popularized.