硬膜外麻醉与腰硬联合麻醉在分娩镇痛中的应用比较

目的比较在分娩镇痛中分别应用硬膜外麻醉与腰硬联合麻醉的价值。方法 140例行分娩镇痛的初产妇,按照数字抽签法分为对照组和观察组,每组70例。对照组产妇应用硬膜外麻醉,观察组产妇应用腰硬联合麻醉。比较两组产妇不同时间阶段的镇痛效果以及镇痛起效时间、产后出血量。结果麻醉后5、10、30、60、90 min,观察组产妇视觉模拟评分法(VAS)评分均低于对照组,差异具有统计学意义(P<0.05)。观察组产妇镇痛起效时间为(2.84±1.35)min,短于对照组的(6.71±2.50)min,差异具有统计学意义(t=11.3961, P=0.0000<0.05)。观察组产妇产后出血量为(206±17)ml,与对照组的(211±13)ml比较差异无统计学意义(t=1.9547, P=0.0526>0.05)。结论对行分娩镇痛的产妇应用腰硬联合麻醉,可显著缩短镇痛的起效时间,维持镇痛效果,推广可行性较大。

Comparison of epidural anesthesia and combined spinal and epidural anesthesia in labor analgesia

Objective To compare the value of epidural anesthesia and combined spinal and epidural anesthesia in labor analgesia. Methods A total of 140 primiparas with labor analgesia were divided into control group and observation group by lottery method, with 70 cases in each group. The control group received epidural anesthesia, and the observation group received epidural anesthesia in labor analgesia. The analgesic effect at different time period, onset time of analgesia and amount of postpartum hemorrhage of the two groups were compared. Results At 5, 10, 30, 60 and 90 min after anesthesia, the visual analogue scale(VAS) score in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05). The onset time of analgesia(2.84±1.35) min in the observation group was shorter than(6.71±2.50) min in the control group, and the difference was statistically significant(t=11.3961, P=0.0000<0.05). The amount of postpartum hemorrhage was(206±17) ml in the observation group, which had no statistically significant difference compared with(211±13) ml in the control group(t=1.9547, P=0.0526>0.05). Conclusion Application of combined spinal and epidural anesthesia for labor analgesia can significantly shorten the onset time of analgesia, and maintain the effect of analgesia. It is worthy of promotion.