|
|
|
| Application comparison of dural penetrating epidural block and direct epidural block in labor analgesia |
| YAN Ming1 ZHANG Yufeng1 LI Xiaoqiong2 CUI Enhui1 DING Song1 SUN Jian1 |
1.Department of Anesthesiology, Huai’an Maternal and Child Health Care Hospital, Jiangsu Province, Huai’an 223002, China;
2.Department of Obstetrics and Gynecology, Huai’an Maternal and Child health Care Hospital, Jiangsu Province, Huai’an 223002, China |
|
|
|
Abstract Objective To compare the application effect of dural penetrating epidural block and direct epidural block in labor analgesia. Methods From January 2019 to January 2020, 112 parturients who need labor analgesia in Huai’an Maternal and Child Health Hospital of Jiangsu Province were selected as study objects. They were divided into group A and B according to random number table method, with 56 parturients in each group. Group A was received direct epidural block analgesia and group B was received dural penetrating epidural block analgesia. The changes of each index were monitored between two groups. Results There were no significant differences in labor stages and neonatal Apgar score between two groups (P > 0.05). There was no significant difference in visual analogue scale (VAS) score between two groups before analgesia (P > 0.05), after analgesia, VAS scores at each time point in group B were lower than those in group A, and the differences were statistically significant (P < 0.05). The levels of serum pain mediators 5-hydroxy tryptamine, substance P and neuropeptide in the first, second and third labor stages in group B were lower than those in group A, with statistically significant differences (P < 0.05). The rate of good analgesia in group B was higher than that in group A, and the difference was statistically significant (P < 0.05). There was no significant difference in the incidence of adverse events and delivery mode between two groups (P > 0.05). The labor satisfaction of group B was higher than that of group A, and the difference was statistically significant (P < 0.05). Conclusion Compared with direct epidural block, the application value of dural penetrating epidural block in labor analgesia is relatively ideal.
|
|
|
|
|
|
[1] 高容容，郭丽琼，李健，等.分娩镇痛与妊娠结局的相关性分析[J].中国医学前沿杂志：电子版，2020，12（9）：80-83.
[2] 汪琳，王欣，范裕如，等.硬膜外分娩镇痛期间产间发热的影响因素分析[J].中国现代医学杂志，2020，30（13）：75-79.
[3] 孙岳琴，郭益萍.无痛分娩对初产妇的分娩效果、视觉模拟疼痛评分及应激反应的影响[J].中国妇幼保健，2019， 34（20）：4630-4632.
[4] 周国伟，边丹秀，徐萌艳.腰麻及硬膜外麻醉联合应用于产科分娩镇痛的临床探讨[J].中国性科学，2016，25（1）：120-122.
[5] 郑晶晶，董小琼，何美珍，等.不同分娩体位对高龄产妇分娩结局及疼痛程度的影响[J].中国妇幼保健，2020，35（18）：3350-3352.
[6] 冯世苗，贺腾，李华凤.认识分娩疼痛的身心整体治疗[J].医学与哲学，2020，41（6）：68-70.
[7] 于锌，时莉芳，范静.分娩镇痛对产程及母婴转归影响的回顾性临床研究[J].河北医科大学学报，2020，41（6）：731-734.
[8] 刘晓燕.硬膜外阻滞用于无痛分娩的临床效果分析[J].中国药物与临床，2020，20（9）：1511-1513.
[9] 吴伟东，钱震，戴君.硬膜外阻滞分娩镇痛不同给药方式对产妇运动功能及分娩结局影响[J].中国计划生育学杂志，2020，28（5）：706-709，713.
[10] 牟云.硬膜外阻滞麻醉用于分娩镇痛的价值研究[J].河北医药，2019，41（12）：1867-1869.
[11] 何才，俞瑾，李有长，等.硬膜外阻滞联合超声引导下阴部神经阻滞分娩镇痛的效果[J].临床麻醉学杂志，2019， 35（4）：340-343.
[12] 李林.蛛网膜下腔阻滞联合硬膜外阻滞麻醉对镇痛分娩的效果观察[J].中国计划生育学杂志，2018，26（3）：225-227.
[13] Lu YY，Cai JJ，Jin SW，et al. Application of dural puncture epidural technique for labor analgesia [J]. Zhonghua Yi Xue Za Zhi，2020，100（5）：363-366.
[14] 蒋焕伟，杨祖权，涂碧华.连续硬膜外阻滞分娩镇痛失败的原因及补救措施[J].中国医师进修杂志，2016，39（8）：693-696.
[15] 晏明，张玉凤，崔恩惠，等.硬脊膜穿破硬膜外阻滞在分娩镇痛中的应用[J].国际麻醉学与复苏杂志，2020，41（8）：763-768.
[16] Layera S，Bravo D，Aliste J，et al. A systematic review of DURAL puncture epidural analgesia for labor [J]. J Clin Anesth，2019，53（1）：5-10.
[17] 卢园园，蔡嘉靖，金绍武，等.硬脊膜穿破硬膜外阻滞在产妇分娩镇痛中的应用[J].中华医学杂志，2020，100（5）：363-366.
[18] 宋玉洁，徐振东，刘志强.硬脊膜穿破硬膜外阻滞技术在分娩镇痛中的研究进展[J].国际麻醉学与复苏杂志，2019，40（2）：171-174.
[19] 王一男，徐丽，徐铭军.硬脊膜穿破硬膜外阻滞在妊娠期高血压疾病产妇分娩镇痛中的应用[J].临床和实验医学杂志，2020，19（7）：774-778.
[20] 蔡文举，熊晓林，洪金兰，等.氢吗啡酮静脉自控镇痛对乳腺癌术后疼痛的控制作用及对患者血清5-HT和hs-CRP的影响[J].中国药师，2019，22（12）：2240-2242.
[21] 周泓屹，曹忠，侯振环.初产妇椎管内阻滞镇痛对产妇血清SP、NPY等因子水平及阴道助产率的影响分析[J].湖南师范大学学报：医学版，2020，17（4）：167-169.
[22] Diaz-delCastillo M，Woldbye DPD，Heegaard AM. Neuropeptide Y and its Involvement in Chronic Pain [J]. Neuroscience，2018，387：162-169. |
|
|
|
