Abstract:Objective To compare the safety and efficacy of the whole stage epidural labor analgesia and whole stage electrical stimulation combined with epidural labor analgesia. Methods From December 2016 to December 2017, a total of 200 cases of puerperas in Tianjin Central Obstetrics and Gynecology Hospital were selected as the research objects and divided into the whole stage epidural labor analgesia group (group B) and the whole stage electrical stimulation combined with epidural labor analgesia group (group C) by the random number table, with 100 cases in each group. The puerperas who received caesarean section were eliminated, with 85 cases in group B and 93 cases in group C. Group B was given epidural labor analgesia in the latent phase (after uterine contractions regularly), group C was given electrical stimulation in incubation period of first production process and epidural labor analgesia after uterine contractions regularly as in group B (when the uterus cervix was 3 cm). The time for the first stage of labor and the scores of visual analogue scale (VAS) at the uterus cervix 2, 4, 6, 8 cm and 10 cm were recorded. The blood gas analysis of umbilical artery of neonates (includes pH value, carbon dioxide partial pressure, oxygen partial pressure, lactic acid, residual alkali.) and the Apgar score after 1 min of delivery were recorded. Results The cesarean section rate in group B was higher than that of group C, the first stage of labor time in group B was longer than that of group C, with statistically significant differences (P < 0.05). At the uterine cervix 2 cm, the VAS score in group B was lower than that of group C, with statistically significant difference (P < 0.05). There were no statistically significant differences at the uterine cervix 4 cm and 6 cm between the two groups(P > 0.05). At the uterine cervix 8 cm and 10 cm, the VAS scores in group B were higher than those of group C, with statistically significant differences (P < 0.01). There were no statistically significant differences between the two groups in the blood gas analysis of umbilical artery and the 1 min Apgar score after birth (P > 0.05). Conclusion The whole stage electrical stimulation combined with epidural labor analgesia is safe and effective for puerperas with natural labor.
吕宁 吕艳 李莉. 经皮神经电刺激联合硬膜外阻滞全产程分娩镇痛的安全性及有效性[J]. 中国医药导报, 2018, 15(6): 94-97.
LYU Ning LYU Yan LI Li. The safety and efficacy of the whole stage electrical stimulation combined with epidural labor analgesia. 中国医药导报, 2018, 15(6): 94-97.
[1] Kuczkowski KM,Chandra S. Maternal satisfaction with single-dose spinal analgesia for labor pain in Indonesia:a landmark study [J]. Anesth,2008,22(1):55-58.
[2] Lowe N. The nature of labor pain [J]. Am J Obstet Gynecol,2002,186(5):516-524.
[3] 李冰,陈绪军,郭艳,等.不同浓度罗哌卡因复合舒芬太尼在硬膜外阶梯式分娩镇痛中的应用[J].临床麻醉学杂志,2016,32(4):361-365.
[4] 谭素云,黄霄行,韩全国.罗哌卡因复合舒芬太尼硬膜外和腰硬联合阻滞用于无痛分娩的临床观察[J].中外医学研究,2014,12(10):32-33.
[5] Peng T,Li XT,Zhou SF,et al. Transcutaneous electrical nerve stimulation on acupoints relieves labor pain:a non-randomized controlled study [J]. Chin J Integr Med,2010, 16(3):234-238.
[6] Tseng CC,Chang CL,Lee JC,et al. Attenuation of the Catecholamine Response by Electroacupuncture on Jen-Chung Point During Post-operative Recovery Period in Humans [J]. Neuro science Letters,2007,228(3):187.
[7] Chao AS,Chao A,Wang TH,et al. Pain relief by applying transcutancous electrical nerve stimulation(TENS) on acupuncture points during the fist stage of labor:a randomized doule-blind place-controlled trail [J]. Pain,2007,1279(3):214-220.
[8] 王大伟,王保国,刘长宝.不同剂量罗哌卡因复合舒芬太尼腰-硬联合阻滞在产程潜伏期分娩镇痛的效果[J].临床麻醉学杂志,2015,31(6):538-542.
[9] Pandya ST. Labouranalgesia:Recentadvances [J]. IndianJ Anaesth,2010,54(5):400-408.
[10] Wang F,Shen X,Guo X,et al. Epidural analgesia in the latent phase of labor and the risk of cesarean delivery:a five-year randomized controlled trial [J]. Anesthesiology,2009,111(4):871 880.
[11] Lin R,Tao Y,Yu Y,et al. Intravenous Remifentanil versus Epidural Ropivacaine with Sufentanil for Labour Analgesia:A Retrospective Study [J]. PLoS One,2014,9(11):e112 283.
[12] 王莉,李艳华,张培俊.不同时机硬膜外分娩镇痛对产程及母婴的影响[J].临床麻醉学杂志,2011,27(7):664-666.
[13] Segado Jiménez MI,Arias DJ,Dominguez HF,et al. Epidural analgesia in obstetrics:is there an effect on labor and delivery? [J]. Rev Esp Anestesiol Reanim,2011,58(1):11-16.
[14] Torvaldsen S,Roberts CL. No increased risk of caesarean or instrumental delivery for nulliparous women who have epidural analgesia early in(term)labour [J]. Evid Based Med,2012,17(1):21-22.
[15] Wong CA,Scavone BM,Peaceman AM,et al. The risk of cesarean delivery with neuraxal analgesia given early versus late in labor [J]. N Engl J Med,2005,352(7):665-667.
[16] Alexander JM,Sharma SK,Mclntire DD,et al. Epidural analgesia lengthens the Friednman active phase of labor [J]. Obstet Gynecol,2002,100(1):46-50.
[17] 张渺,杨慧霞,史彗星,等.腰麻-硬膜外联合镇痛产程分析进展[J].中国妇产科临床杂志,2005,6(1):32-34.
[18] Zhang J,Troendle JF,Yancey MK. Reassessing the labor curve in nulliparous women [J]. Am J Obstet Gyneecol,2002,187(4):824-828.
[19] 吴振,陈家骅,王义桥,等.经皮穴位电刺激对小儿扁桃体切除后躁动的影响[J].临床麻醉学杂志,2012,28(1):28-30.
[20] 蒋秋燕,高忆,唐乾利,等.按摩合谷穴位对第一产程镇痛效果的临床观察[J].按摩与康复医学,2011,48(4):4-5.
[21] 梁锐枝,朱怀郡,梁剑江,等.罗哌卡因复合舒芬太尼应用于腰麻-硬膜外联合阻滞麻醉在分娩镇痛中的应用效果[J].中国医药科学,2016,6(12):104-107.
[22] 贺淑君,张娟,雷波,等.经产妇硬膜外自控分娩镇痛的临床观察[J].中国现代医生,2017,55(18):105-107, 111.
[23] 蓝丽霞,平永美,李中华.右美托咪定联合罗哌卡因硬膜外自控镇痛在足月妊娠产妇分娩中的临床研究[J].中国现代医生,2017,55(26):112-115.