编程间歇性外周螺旋减轻了分娩疼痛缓解中的工作负载:一个中心的经验
1Department of Anesthesiology, Shin Kong Memorial Wu Ho-Su Hospital, No. 95, Wen Chang Road, Shih Lin District, Taipei 111, Taiwan.
Medicina (Kaunas, Lithuania)
|June 27, 2024
概括
与患者控制的外周止痛疗法 (PCEA) 结合的编程间歇性外周止痛疗法 (PIEB) 与连续外周输液 (CEI) 加PCEA相比,减少了非预定的访问和劳动人员在产后外周止痛疗法的工作负担. 这种方法也减少了某些副作用,尽管需要对PIEB设置进行进一步的研究.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 疼痛管理 疼痛管理
背景情况:
- 可以使用连续外周输液 (CEI),编程间歇性外周玻尿酸 (PIEB) 或患者控制的外周止痛 (PCEA) 来维持产后外周止痛.
- 从CEI+PCEA过渡到PIEB+PCEA,引发了人们对副作用增加和员工工作量增加的担忧.
研究的目的:
- 评估PIEB+PCEA协议是否有效地减少了产科麻醉单位的员工工作负担.
- 为了比较PIEB+PCEA和CEI+PCEA之间的非计划访问,副作用和分娩/新生儿结果的发生率.
主要方法:
- 一个两年后的回顾,分娩的分娩者接受了阴道分娩的外周止痛.
- 两组人员负担的比较:A组 (CEI+PCEA) 和B组 (PIEB+PCEA).
- 主要结局:分娩需要非预定访问的分娩者比例的差异;次要结局:副作用和分娩/新生儿结局.
主要成果:
- 与CEI+PCEA组 (A组) (27.7%) 相比,PIEB+PCEA组 (B组) 的非预定访问比例 (20.8%) 显著较低.
- 多变量分析证实,PIEB与更少的非计划性访问有关 (OR = 0.53).
- 在B组,不对称性和运动阻塞的发生率较低. 无卵性女性经历的产科关节损伤较少. 然而,B组的多孕妇有更多的真空辅助分娩和更长的第二阶段分娩.
结论:
- 与CEI+PCEA相比,PIEB+PCEA协议成功地减少了与CEI+PCEA相比,在分娩外周止痛方面的工作量,即使使用了更高的止痛剂量.
- 虽然PIEB+PCEA降低了某些副作用,但对分娩进展的潜在影响,比如在多胎妇女中增加真空提取的使用,需要考虑.
- 建议进行进一步的研究,以探索最佳的PIEB设置及其对劳动结果的影响.
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