间歇硬膜外输注和连续硬膜外输注联合患者自控硬膜外镇痛在分娩镇痛中的应用效果及安全性比较

Abstract
Figure/Table
References (31)
Related Citation (15)

Download: PDF (970 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To study the application effect and safety of intermittent epidural bolus (IEB) and continuous epidural infusion (CEI) combined with patient-controlled epidural analgesia (PCEA) in labor analgesia. Methods From January to July 2020, 80 full-term primiparas who voluntarily accepted epidural labor analgesia were selected as the research objects. According to the random number table method, they were divided into study group (40 cases) and control group (40 cases). Control group was treated with CEI combined with PCEA, and study group was treated with IEB combined with PCEA. The first, second, third stage of labor, blood loss, cesarean section rate were compared between two groups; visual analogue scale (VAS) score of pain before analgesia, 10, 30, 60 min after analgesia, and when the uterine orifice was fully opened were compared between two groups; the time of the first PCEA, PCEA usage rate and analgesic dosage, the time of the first burst of pain, the size of uterine orifice at the time of the first burst of pain, the incidence rate of burst pain, the total satisfaction degree and the total incidence of complications were compared between two groups. Results There were no significant differences in the first, second, third stage of labor, blood loss, and cesarean section rate between two groups (P > 0.05). VAS scores of two groups were lower than those before analgesia on 10, 30, 60 min after analgesia, and when the uterine orifice was fully opened (all P < 0.05); while there were no significant differences in VAS scores between two groups at each time point (P > 0.05). There were no significant differences in the time of the first PCEA and PCEA usage rate between two groups (P > 0.05); while the analgesic dosage in study group was lower than that in control group (P < 0.05). The time of the first burst of pain in study group was longer than that in control group, and the size of uterine orifice at the time of the first burst of pain was larger than that in control group, and the incidence rate of burst pain was lower than that in control group (all P < 0.05). The total satisfaction of study group was higher than that of control group (P < 0.05). There was no significant difference in the total incidence of complications between two groups (P > 0.05). Conclusion In epidural labor analgesia, IEB has better effect, can effectively reduce the incidence of burst pain, safe and reliable, and has clinical application value.

Key words： Labor analgesia Epidural Anesthesia mode Intermittent epidural bolus Continuous epidural infusion Patient-controlled epidural analgesia Efficacy Complication

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHANG Hongzhi YE Chunfang HUANG Wenxin

Cite this article:

ZHANG Hongzhi YE Chunfang HUANG Wenxin. Application effect and safety comparison of intermittent epidural bolus and continuous epidural infusion combined with patient-controlled epidural analgesia in labor analgesia[J]. 中国医药导报, 2021, 18(19): 118-121，133.

URL:

https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I19/118

[1] 王峰波，魏学功.分娩镇痛的应用研究进展[J].中国现代医药杂志，2020，22（2）：106-108.
[2] Malevic A，Jatuzis D，Paliulyte V. Epidural Analgesia and Back Pain after Labor [J]. Medicina（Kaunas），2019，55（7）：354.
[3] 戚芳，黄绍强，丁焱.中国分娩镇痛服务的现状调查与分析[J].中国妇幼保健，2019，34（9）：1937-1941.
[4] 张静，程吉，陶峰，等.连续硬膜外阻滞分娩镇痛对分娩及新生儿结局的影响[J].中国医药，2020，15（3）：443-446.
[5] 刘君儿，曹卫洁，李珑.椎管内阻滞分娩镇痛发展现状[J].现代临床医学，2021，47（3）：195-198.
[6] 付秋鹏，何银芳，高连峰，等.不同分娩镇痛方式对妊娠结局影响的研究进展[J].中国全科医学，2020，23（10）：1318-1322.
[7] 沈晓凤，姚尚龙.分娩镇痛专家共识（2016版）[J].临床麻醉学杂志，2016，32（8）：816-818.
[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] 吉杰，徐振东，金春红，等.间断硬脊膜外腔注射与持续硬脊膜外腔输注在患者自控硬脊膜外腔分娩镇痛中的比较[J].上海医学，2016，39（8）：461-465.
[10] 王燕，罗碧如，徐鑫芬，等.我国医疗机构分娩镇痛现状调查研究[J].护理学杂志，2020，35（12）：16-19，41.
[11] Poma S，Scudeller L，Verga C，et al. Effects of combined spinal-epidural analgesia on first stage of labor：a cohort study [J]. J Matern Fetal Neonatal Med，2019，32（21）：3559-3565.
[12] 孙天华.分娩镇痛普及的必要性及其规范化管理流程[J].继续医学教育，2021，35（4）：133-135.
[13] 林君飞，梁刚，林雪芹.不同镇痛方式对分娩的镇痛效果及其对分娩结局的影响[J].中国妇幼健康研究，2021，32（3）：406-409.
[14] 姚腊梅，李元海，朱海娟，等.硬膜外程控间歇脉冲式分娩镇痛对母婴安全的影响[J].临床麻醉学杂志，2019， 35（9）：889-892.
[15] 张晶，薛宁，李胜男，等.腰麻联合硬膜外间歇脉冲输注对分娩产妇镇痛及脐带血GSH、β-Car的影响[J].广西医科大学学报，2019，36（9）：1456-1461.
[16] 李飞，李兴源，陈丽珍，等.机械泵持续硬膜外注射与电子脉冲泵间歇性注射麻醉剂对分娩镇痛效果的比较[J].临床和实验医学杂志，2020，19（17）：1876-1879.
[17] 张富杰，夏俊龙，孟凡浩.腰硬联合麻醉与连续硬膜外麻醉在潜伏期分娩镇痛中应用的比较[J].中国医药导报，2019，16（16）：112-115.
[18] 包菊，邓春梅，曲元.不同硬膜外镇痛模式对肥胖产妇镇痛效果和分娩方式的影响[J].临床麻醉学杂志，2019， 35（10）：948-951.
[19] Gunaydin B，Erel S. How neuraxial labor analgesia differs by approach：dural puncture epidural as a novel option [J]. J Anesth，2019，33（1）：125-130.
[20] 宋毅文，王志力，邱玲玲，等.PCEA联合硬膜外间歇脉冲输注镇痛对分娩产妇运动功能及新生儿窒息的影响[J].医学食疗与健康，2019（17）：58-59.
[21] 杜继贤，李波.硬膜外持续给药和规律间断给药对足月初产妇分娩的影响[J].中外医学研究，2021，19（12）：138-140.
[22] 龙廷辉.连续性硬膜外麻醉对产妇无痛分娩镇痛效果、产程及母婴结局的影响[J].中国当代医药，2020，27（13）：118-120.
[23] 程边媛，陈红波，方向东，等.硬膜外分娩镇痛对初产妇产程曲线的影响[J].现代妇产科进展，2019，28（4）：290-292，295.
[24] 董金填，李群杰，姚伟瑜.瑞芬太尼静脉分娩镇痛的研究进展[J].临床麻醉学杂志，2019，35（6）：607-610.
[25] 张健光，许晓艳，管晓丽.分娩镇痛对产程、分娩方式及母婴结局的影响分析[J].中国妇幼保健，2019，34（5）：1032-1034.
[26] 宋毅文，叶智荣，胡细苟，等.PCEA联合IEB镇痛对分娩产妇运动功能的影响[J].中国处方药，2019，17（5）：143-144.
[27] 高锦文，詹伟海，黎惠斌，等.程控硬膜外间歇脉冲输注与持续硬膜外输注在分娩镇痛中的应用[J].临床医学工程，2020，27（10）：1331-1332.
[28] 岑盛华，余颖，严潮阳.硬膜外腔给药途径患者自控镇痛联合硬膜外间歇脉冲输注麻醉对高龄产妇产程及炎症细胞因子水平的影响[J].中国妇幼保健，2020，35（10）：1805-1807.
[29] 王志力，张志煜.硬膜外自控联合硬膜外间歇脉冲输注镇痛对新生儿Apgar评分及窒息的影响[J].中国处方药，2019，17（4）：142-143.
[30] 郑涤凡，何依红，钟林菁.罗哌卡因复合舒芬太尼硬膜外自控镇痛在无痛分娩中的镇痛效果和对母婴的安全性[J].中国现代医生，2020，58（13）：129-132.
[31] 梁太汉，陈永华，王洁茹.不同间隔时间行程控硬膜外脉冲式注射用于分娩镇痛的效果研究[J].中国医药科学，2020，10（21）：188-191.