杜拉穿刺外围注射技术与编程间歇性外围注射玻尿酸模式在分娩止痛中的应用:一项随机临床试验
Ming Yan1, Qiao Wang, Yufeng Zhang
1Department of Anesthesiology, The Huai'an Maternity and Child Clinical College of Xuzhou Medical University (Huai'an Maternal and Child Health Care Center), Huaian, China.
Medicine
|November 7, 2023
概括
与编程间歇性外周玻尿酸 (PIEB) 连接的持续刺穿外周 (DPE) 与传统外周技术相比,提供更快的分娩止痛和更少的药物使用. 这种组合可能是分娩期间疼痛管理的优越方案.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 劳动止痛对于母亲的福祉至关重要.
- 常规外围注射 (EP) 与连续外围注射 (CEI) 是一种标准方法.
- 长时间刺穿外围注射 (DPE) 和编程间歇性外围注射 (PIEB) 是替代的技术.
研究的目的:
- 为了比较DPE与PIEB的疗效和安全性,与CEI用于分娩止痛的传统EP相比.
- 评估发病,维持,副作用和新生儿结局.
主要方法:
- 随机对照试验涉及455名女性.
- 有四个小组:EP+CEI,EP+PIEB,DPE+CEI,DPE+PIEB. 这四个小组分别是:EP+CEI,EP+PIEB,DPE+CEI,DPE+PIEB.
- 关键结局包括止痛时间,药物消耗,阻塞特征和新生儿Apgar分数.
主要成果:
- 与EP技术相比,DPE技术 (DPE+CEI和DPE+PIEB) 实现了更快的疼痛缓解 (NRS ≤ 1).
- 在DPE+PIEB组显示显著降低了罗皮瓦卡因的消费,并减少了不完全止痛和产后发烧的发生率.
- 新生儿Apgar分数在不同组之间没有显著差异.
结论:
- 长期刺穿外周 (DPE) 与传统外周 (EP) 技术相比,提供了更快的分娩止痛.
- 将DPE与编程间歇性外周螺栓 (PIEB) 结合起来,可能代表一个优越的分娩止痛方案.
- 这些发现表明DPE和PIEB在增强分娩疼痛管理经验方面具有潜在的优势.
相关概念视频
Local Anesthetics: Clinical Application as Epidural Anesthesia
438
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
438
Local Anesthetics: Clinical Application as Spinal Anesthesia
646
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
646
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
435
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
435
Drug Delivery: Parenteral Route
570
The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
570
Parenteral Anesthetics: Overview
135
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
135
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.1K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.1K


