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| Effect of ultrasound-guided bilateral pudendal nerve block combined with epidural block on perineal protection and pregnancy outcome of spontaneous delivery parturient |
| ZHOU Jialong LI Chabing WANG Yiqiao |
| Department of Anesthesiology, the Second People’s Hospital of Anhui Province, Anhui Province, Hefei 230000, China |
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Abstract Objective To explore the effect of ultrasound-guided bilateral pudendal nerve block combined with epidural block on perineal protection and pregnancy outcome of spontaneous delivery parturient. Methods From January 2019 to June 2020, 80 cases spontaneous delivery parturient who were hospitalized in the Second People’s Hospital of Anhui Province for delivery were selected as study subjects. According to the random number table method, they were divided into control group and study group, with 40 cases in each group. The control group were received epidural block, and the study group were received ultrasound-guided bilateral pudendal nerve block combined with epidural block. The perineal conditions and visual analogue score (VAS) at different time points (full hysterectomy [T1], fetal head exposure [T2], perineal suture [T3]) of two groups were compared, and the pregnancy outcomes of two groups were observed. Results The perineal integrity rate of study group was higher than that of control group, and the perineal lateral resection rate was lower than that of the control group, and the differences were statistically significant (all P < 0.05). There was statistical significance in the degree of perineal laceration between two groups (P < 0.05). VAS at T2 and T3 in the two groups were lower than those at T1, and the differences were statistically significant (all P < 0.05). VAS at T2 and T3 in study group were lower than those in control group, and the differences were statistically significant (all P < 0.05). The time of the second stage of labor in study group was shorter than that in control group; Apgar score of neonates was higher than that of control group, and the differences were statistically significant (all P < 0.05). The neonatal asphyxia rate and postpartum hemorrhage rate in study group were lower than those in control group, and the differences were statistically significant (all P < 0.05). Conclusion Ultrasound-guided bilateral pudendal nerve block combined with epidural block has significant effect on perineal protection of parturient, significantly shorten the labor process time of parturient and effectively reduce adverse pregnancy outcomes.
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[1] 张志敏，高运合，徐小溪，等.两种麻醉方式联合使用对会阴部撕裂程度及宫缩疼痛程度的影响[J].中国性科学，2018，27（11）：82-85.
[2] 秦静.无创接生联合阴部神经阻滞麻醉在自然分娩中的应用价值[J].湖南师范大学学报：医学版，2017，14（2）：94-97.
[3] 王育芬，叶云玲，王茜.不同助产方式配合无保护会阴接生的临床分析[J].中国计划生育和妇产科，2015，7（3）：24-26，47.
[4] 中华医学会麻醉学分会产科学组.分娩镇痛专家共识（2016版）[J].临床麻醉学杂志，2016，32（8）：816-818.
[5] 顾冬芹.阴部神经阻滞麻醉联合会阴适度保护在自然分娩产妇中的应用[J].全科护理，2018，16（34）：4271-4273.
[6] 王敏.导乐仪联合阴部神经阻滞麻醉对产程及分娩结局的影响[J].临床医药文献杂志，2019，6（12）：83，86.
[7] 贺豪杰，郭红燕，韩劲松，等.B超引导与传统手法阴部神经阻滞治疗女性阴部神经痛的比较[J].中国微创外科杂志，2017，17（2）：151-154.
[8] 严广斌.视觉模拟评分法[J].中华关节外科杂志：电子版，2014，8（2）：273.
[9] 黄月婷.硬膜外麻醉联合无保护会阴接生应用于自然分娩的临床研究[J].中国现代药物应用，2018，12（5）：16-17.
[10] 马丽，张玉蕊.分析硬膜外麻醉下行椎管内置管止痛术对产妇妊娠结局影响[J].中国实用医药，2018，13（22）：75-77.
[11] 叶辉，刘敏杰，袁桂静，等.硬膜外神经阻滞麻醉对无痛分娩初产妇医院感染及母婴结局的影响[J].中华医院感染学杂志，2019，29（19）：3027-3030.
[12] 徐婧，曲元.第二产程有背景剂量硬膜外分娩镇痛对产程和分娩结局的影响[J].临床麻醉学杂志，2016，32（12）：1158-1161.
[13] Bendtsen TF，Parras T，Moriggl B，et al. Ultrasound-guided pudendal next block at entrance of the pudendal（alcock）canal：description of anatomy and clinical technique [J]. Reg Anesth Pain Med，2016，41（2）：140-145.
[14] 李红.双侧阴部神经阻滞在自然分娩中的应用效果观察[J].临床合理用药，2015，8（5）：130-131.
[15] 姜静婧，冯璐，薛伟力，等.超声引导下阴部神经阻滞用于PPH术后镇痛的效果观察[J].中华结直肠疾病电子杂志，2017，6（5）：392-396.
[16] 张驰，冶文磊，冉建华.阴部神经的解剖学观测及其临床意义[J].中国临床解剖学杂志，2016，34（4）：366-369.
[17] 郑后，顾凯芬，余佩红.阴部管内神经阻滞麻醉配合无保护会阴接生的效果观察[J].浙江医学教育，2017，16（2）：44-47.
[18] 朱骏，刘兰萍，嵇曹，等.双侧阴部和会阴神经阻滞麻醉联合无保护助产在自然分娩中临床应用[J].中国医院用药评价与分析，2016，16（S1）：160-162.
[19] Christopher JM，Mark CK. Precision and efficacy of a new ultrasound-guided pudendal nerve block technique in children [J]. Paediatr Anaesth，2018，28（6）：572.
[20] 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.
[21] 颜娅，何才，梅杨，等.超声引导下阴部神经阻滞在分娩镇痛及会阴保护中的临床效果观察[J].第三军医大学学报，2019，41（10）：987-990.
[22] Isabelle GF，Pablo DLA，Sophie B，et al. Ultrasound-guided pudendal nerve block in children：A new technique of ultrasound-guided transperineal approach [J]. Paediatr Anaesth，2018，28（1）：53-58.
[23] 韩杰.双侧阴部神经阻滞麻醉会阴无保护或适度保护在阴道分娩中的应用[J].青海医药杂志，2016，46（8）：23-24.
[24] 张萍，黄萍.双侧阴部神经阻滞麻醉配合无保护会阴接生法在初产妇自然分娩中的应用效果评价[J].当代医药论丛，2017，15（8）：29-30.
[25] 杨会茹.腰麻联合双管硬膜外麻醉在分娩镇痛中的应用效果及护理[J].河南医学研究，2017，26（1）：185-186.
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