不同穿刺点椎管内麻醉分娩镇痛对产妇产程及母婴结局的影响
Effects of Intraspinal Anesthesia for Labor Analgesia at Different Puncture Points on Delivery Process and Maternal and Neonatal Outcomes
叶海宾 1皇甫彪 1李莉 2白耀武1
作者信息
- 1. 063000 河北唐山,唐山市妇幼保健院麻醉科
- 2. 063000 河北唐山,唐山市妇幼保健院产科
- 折叠
摘要
目的 探讨不同穿刺点椎管内麻醉分娩镇痛对产妇产程及母婴结局的影响.方法 选取2022 年1 月至2024 年2 月行椎管内麻醉分娩镇痛的120 例阴道分娩产妇,采用随机数表法分为高位麻醉组(n=60)和低位麻醉组(n=60),2 组产妇均采用程控硬膜外间歇脉冲注入+患者自控硬膜外镇痛,高位麻醉组行L1～2穿刺椎管内麻醉,低位麻醉组行L3～4穿刺椎管内麻醉.比较2 组产妇失血量、产程总时长、麻醉指标、产妇分娩情况、新生儿结局以及不良反应发生情况.结果 2 组产妇失血量比较差异无统计学意义(P＞0.05).高位麻醉组产妇产程总时长较低位麻醉组短(P＜0.05).高位麻醉组产妇运动阻滞起效时间、感觉阻滞起效时间和感觉恢复时间均较低位麻醉组短,且麻醉阻滞神经节段数较低位麻醉组显著减少(P＜0.05).高位麻醉组产妇的第一产程和第二产程时间均较低位麻醉组短(P＜0.05).2 组产妇的中转剖宫产率、阴道助产率和阴道分娩率比较差异无统计学意义(P＞0.05).高位麻醉组新生儿出生后 1 和 5 min的Apgar评分均较低位麻醉组高(P＜0.05).高位麻醉组产妇不良反应总发生率为 8.33%(5/60),低位麻醉组为10.00%(6/60),2 组比较差异无统计学意义(P＞0.05).结论 L1～2 穿刺椎管内麻醉在产妇分娩镇痛中具有较好效果,可以缩短产程,提高新生儿Apgar评分,且未显著增加不良反应.
Abstract
Objective To investigate the effect of intraspinal anesthesia for labor analgesia at different puncture points on delivery process and maternal and neonatal outcomes.Methods A total of 120 parturients who underwent intraspi-nal anesthesia for labor analgesia and vaginal delivery from January 2022 to February 2024 were selected,and divided into high spinal anesthesia group(n=60)and low spinal anesthesia group(n=60)by random number table method.All parturi-ents in both groups received program-controlled epidural intermittent pulse injection+patient-controlled epidural analgesia.The high spinal anesthesia group received L1-2 intraspinal anesthesia,and the low spinal anesthesia group received L3-4 intraspi-nal anesthesia.Maternal blood loss,total duration of labor,anesthesia indexes,maternal delivery,neonatal outcomes and ad-verse reactions were compared between the two groups.Results There was no significant difference in maternal blood loss be-tween the two groups(P＞0.05).The total duration of labor in high spinal anesthesia group was shorter than that in low spi-nal anesthesia group(P＜0.05).The onset time of motor block,sensory block and sensory recovery time in high spinal anes-thesia group were shorter than those in low spinal anesthesia group,and the number of anesthesia block ganglia was significant-ly reduced,as compared with low spinal anesthesia group(P＜0.05).The first and second stages of labor in high spinal an-esthesia group were shorter than those in low spinal anesthesia group(P＜0.05).There was no significant difference in cesar-ean section rate,vaginal midwifery rate and vaginal delivery rate between the two groups(P＞0.05).The Apgar score at 1 and 5 min after birth in the high spinal anesthesia group was higher than that in the low spinal anesthesia group(P＜0.05).The total incidence of adverse reactions was 8.33%(5/60)in the high spinal anesthesia group and 10.00%(6/60)in the low spinal anesthesia group,and there was no significant difference between the two groups(P＞0.05).Conclusion L1-2 in-traspinal anesthesia has a good effect on labor analgesia,which can shorten delivery process,improve neonatal Apgar score,and does not significantly increase adverse reactions.
关键词
椎管内麻醉/分娩镇痛/阻滞平面/产妇/产程/母婴结局/不良反应Key words
Intraspinal anesthesia/Labor analgesia/Block plane/Parturient/Delivery process/Maternal and neo-natal outcome/Adverse reaction引用本文复制引用
出版年
2025
国家科技期刊平台
NSTL
万方数据