在分娩和产妇护理期间神经轴痛解的技术方面:更新的概述
Antonio Coviello1, Carmine Iacovazzo2, Maria Grazia Frigo3
1Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", via Sergio Pansini 5, Naples, 80100, Italy. antonio_coviello@live.it.
Journal of anesthesia, analgesia and critical care
|January 29, 2025
概括
有效的分娩止痛涉及各种技术,包括外周止痛和非药物方法. 将技术技能与非技术支持相结合,对于产妇和胎儿在分娩期间的最佳结果至关重要.
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:
- 在全球范围内,劳动止痛药越来越多地被使用,使用率从10%到60%不等.
- 劳动疼痛管理对母亲和胎儿结果的好处是正在进行的科学讨论的主题.
- 劳动的不同阶段需要量身定制的疼痛管理策略.
研究的目的:
- 为提供神经轴和非神经轴分娩镇痛技术的概述.
- 讨论在分娩期间有效照顾母亲所必需的非技术技能.
- 为围绕劳动疼痛管理的关键问题提供见解.
主要方法:
- 从2018年到2023年进行的文献研究.
- 随机对照试验,文献评论,系统评论和元分析的评估.
- 对药理学 (神经轴,氧化,全身阿片类药物) 和非药理学 (TENS,针,芳香疗法,呼吸练习) 方法的评估.
主要成果:
- 神经轴技术包括外围镇痛 (EA),联合脊柱-外围镇痛 (CSE),外围持续刺痛 (DPE) 和连续脊柱麻醉 (CSA).
- 药理选择还包括氧化 (N2O) 和全身性阿片类药物 (吗啡,芬太尼,佩提丁).
- 非药学方法包括TENS,针/针,芳香疗法和呼吸练习.
结论:
- 所有评估的分娩止痛方法都显示出相对安全和有效性.
- 通过将技术技能与必要的非技术支持相结合,可以提高最佳的孕产妇和胎儿结果.
- 需要进一步的研究来确定劳动力镇痛的最佳方法.
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