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手持式超声波辅助与触摸指导的联合脊髓 - 脊膜外注用于分娩止痛:一项随机对照试验

Jinyoung Bae¹, Youngwon Kim², Seokha Yoo³

¹Department of Anesthesiology and Pain Medicine, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Republic of Korea.

Scientific reports

|December 28, 2023

概括

与里程碑指南相比,手持超声波用于分娩止痛 (CSE) 并没有改变整体手术时间,但减少了执行时间,并提高了首次尝试成功率. 在产科中考虑超声波用于联合脊柱-外周止痛.

科学领域:

产科和妇科产科和妇科
麻醉学麻醉学
医学超声波应用医学超声波应用

背景情况:

在产科中的神经轴麻醉,特别是结合脊髓 - 脊周 (CSE) 止痛,是一种常见的疼痛管理技术.
程序前超声指导越来越多地被探索,以提高神经轴阻的安全性和有效性.
传统的基准指导技术可能具有挑战性,可能导致更长的程序时间和更低的成功率.

研究的目的:

调查手持式超声波辅助是否可以缩短与传统的触摸指导方法相比,劳动结合脊髓 - 脊膜 (CSE) 止痛的手术时间.
评估超声波指导对各种程序指标的影响,包括针头操作和成功率.

主要方法:

84名接受分娩止痛治疗的妇女被随机分为两组:手持超声波辅助CSE或触摸引导的CSE.
主要结局是CSE镇痛的总手术时间.
二次结果包括识别时间,执行时间,针头操纵次数,第一次尝试成功率,疼痛得分,意外持续刺痛发生率和患者满意度.

主要成果:

在超声波和触摸组之间,CSE止痛的总过程时间没有显著差异 (P=0.442).
超声波辅助的CSE表现出显著更短的性能时间 (P=0.011) 但更长的识别时间 (P<0.001).
在超声波组,外周周位置的首次尝试成功率明显高于超声波组 (85.7%与59.5%,P=0.014).

结论:

与里程碑指南相比,产前手持超声波辅助产业CSE止痛的结果是相当于总程序时间.
超声指导显著减少了针的执行时间,并增加了首次尝试CSE止痛的成功率.
临床医生可能会考虑将手持式超声波纳入他们的实践,以改善过程效率和成功.

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