外周止痛:对分娩时间和分娩方式的影响 - 一个单中心队列研究
Aleksandra Olszynska1, Zofia Di Martino1, Agnieszka Pawlowska1
1Medical University of Warsaw, Poland.
Ginekologia polska
|June 7, 2023
概括
外周止痛 (EA) 延长了分娩时间,但降低了紧急剖腹产 (CS) 的风险. 这种疼痛管理技术不会对新生儿的结果产生负面影响,为一些分娩者提供了更安全的分娩选择.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 围产儿医学 围产儿医学
背景情况:
- 严重的分娩疼痛可能导致并发症.
- 外周止痛 (EA) 是分娩期间常见的疼痛管理选择.
- 关于EA对分娩时间和分娩方式的影响仍在争论中.
研究的目的:
- 为了确定EA是否会影响分娩第一和第二阶段的持续时间.
- 评估EA对紧急剖腹产 (CS) 和仪器分娩率的影响.
- 评估EA对分娩产生的劳动结果的影响.
主要方法:
- 一项在华沙圣索菲亚专科医院进行的队列研究.
- 纳入标准:年龄在18-40岁之间的分娩者,单独怀孕,头部表现,妊娠年龄在37-42周,新生儿出生体重在2500-4250克之间,接受3-6厘米扩张的EA.
- 对照组没有接受麻醉;计划的CS和VBAC被排除在外. 分析包括所有患者,多对和无对.
主要成果:
- 包括1052名患者 (443名EA,609名对照).
- 经历EA组的劳动持续时间明显更长 (415比255分钟,p <0.01) 和更长的第一和第二阶段 (p <0.01).
- EA与较低的紧急CS风险 (OR = 0.56,p < 0.01) 相关,但仪器交付的可能性更高.
结论:
- 外周止痛延长了分娩的第一和第二阶段.
- EA不会对新生儿的结果产生不利影响.
- 在接受EA的nulliparas中,紧急CS的风险显著降低.
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