|
| 程控间歇脉冲输注联合硬膜外分娩镇痛时产妇爆发痛的相关因素分析 |
| Relevant factors of breakthrough pain during labor analgesia of programmed intermittent epidural bolus combined with patient controlled epidural analgesia |
| |
| DOI：10.12089/jca.2021.12.004 |
| 中文关键词: 分娩镇痛 程控间歇脉冲输注 患者自控硬膜外镇痛 爆发痛 相关因素 |
| 英文关键词: Labor analgesia Programmed intermittent epidural bolus Patient controlled epidural analgesia Breakthrough pain Relevant factors |
| 基金项目:江苏省妇幼健康青年人才项目(FRC201787) |
|
| 摘要点击次数: 1167 |
| 全文下载次数: 475 |
| 中文摘要: |
目的 分析程控间歇脉冲输注联合患者自控硬膜外分娩镇痛模式下产妇发生爆发痛的相关因素。
方法 选择行分娩镇痛的产妇215例，年龄20～45岁，孕期≥37周，单胎头位，ASA Ⅱ或Ⅲ级。行硬膜外穿刺置管后接入电子镇痛泵，参数设置：0.08%罗哌卡因+舒芬太尼0.4 μg/ml，负荷剂量15 ml，脉冲剂量10 ml/h，单次追加剂量8 ml，锁定时间30 min，极限量30 ml/h。当产妇出现爆发痛时给予0.125%罗哌卡因+舒芬太尼0.4 μg/ml共10 ml追加，根据产妇是否发生爆发痛分为两组：爆发痛组和无爆发痛组。记录产妇一般情况和分娩镇痛相关指标。采用单因素方差分析和二分类Logistic回归分析筛选爆发痛的相关因素。
结果 93例（43.2%）产妇发生爆发痛。与无爆发痛组比较，爆发痛组产间发热率明显升高、分娩镇痛满意度明显降低（P<0.05）。两组器械助产率差异无统计学意义。Logistic回归分析显示，硬膜外镇痛中断、镇痛15 min后NRS评分增加和第一产程时间延长是发生爆发痛的独立相关因素。
结论 镇痛15 min后NRS评分增加、硬膜外镇痛中断、第一产程时间延长是硬膜外分娩镇痛后发生爆发痛的独立相关因素。 |
| 英文摘要: |
Objective To observe the relevant factors of breakthrough pain during labor analgesia of programmed intermittent epidural bolus and patient controlled epidural analgesia (PCEA) mode.
Methods A total of 215 parturients who received epidural labor analgesia, aged 20-45 years, gestational age ≥37 weeks, single fetal headed, ASA physical status Ⅱ or Ⅲ were involved. The electronic pump was programmed to administer the first bolus of 15 ml after initiation and 10 ml per hour afterward. An 8 ml PCEA bolus was programmed with a 30-minute lockout. When breakthrough pain occurred, manual supplements of 0.125% ropivacaine with 0.4 μg/ml of sufentanil would be administered. Parturients were divided into two groups according to whether a breakthrough pain occurred: non-breakthrouth pain group and breakthrouth pain group. Demographic, anesthetic, and obstetric-associated factors were recorded during labor. Univariate analysis was used to compare the differences of variables between the two groups, and Logistic regression analysis was performed to screen the relevant factors.
Results Breakthrough pain occurred in 93 parturients (43.2%). Compared with the non-breakthrouth pain group, the rate of intrapartum fever in breakthrouth pain group was increased and the satisfaction degree of labor analgesia was decreased (P < 0.05), and there was no statistical significance in the rate of assisted labor between the two groups. Logistic regression was performed and three independent relevant factors were analgesic interruption, increased NRS 15 minutes after analgesia, prolonged duration of the first stage of labor.
Conclusion Increased NRS score 15 minutes after analgesia, analgesic interruption and prolonged duration of the first stage of labor are the independent relevant factors of breakthrough pain during labor analgesia. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
