摘要
目的探讨妇产科镇痛的开展及常规化实施的可行性。方法自愿接受分娩镇痛的足月孕初产妇58例,中期引产和无痛人工流产孕妇228例,除外有妇产科与麻醉禁忌证者。足月孕初产妇及中期引产的孕妇均采用腰麻-硬膜外联合镇痛(CSEA)和病人自控硬膜外镇痛(PCEA)方法,人工流产的孕妇予以静脉麻醉镇痛。结果分娩及中期引产的孕妇采用CSEA镇痛后,疼痛评分(VAS)从镇痛前的87·7±12·5分及51·1±14·1分,于3min内迅速降低至8·7±8·8分及10·6±6·2分,差异具有显著性(P<0·01),镇痛有效率分别为94%和100%;镇痛后下肢运动阻滞(Bromage评级)全部为0级,均可下地行走。人工流产的孕妇术后均无痛苦记忆,手术时间为15·28±2·57min,异丙酚用量为162·9±39·8mg(约3mg/kg),芬太尼用量为0·05mg,低血压发生率为5·8%。结论妇产科镇痛安全可行,其广泛开展及常规化实施有助于提高医疗质量。
Objective To approach the feasibility of the development and routinely carrying out of gynecological analgesia. Methods A total of 286 pregnant women, 58 were primiparae with full-term fetus and 228 were for mid-term delivery or induced abortion, were enrolled in present study. The combined lumbar-epidural analgesia （CLEA） and the patient-controlled epidural analgesia （PCEA） were given to the primiparae and the ones for mid-term delivery, and the intravenous anesthesia was given to those for induced abortion. Results Among the primiparae and the ones for mid-term delivery, VAS scores were rapidly reduced from 87. 7±12. 5 and 51. 1±14. 1 to 8. 7±8. 8 and 10. 6±6. 2, respectively, within 3 minutes by CLEA, the effective rates of analgesia were 94% and 100%, respectively. For all of them the Bromage evaluation was in 0 degree. After the induction of labor, no algesia memory existed in the women for induced abortion, the operative time was 15. 28±2. 57 minutes, the dosage of propoful was 162. 9±39. 8 rng （about 3mg/kg）, and the dosage of fentanyl was 0. 05 mg. The incidence of hypotension after intravenous anesthesia was 5. 8%. Conclusions Intravenous anesthesia with propoful may remit the panic and fearful sense of pregnant women to induced abortion, and reduce the pain during operation. It is suggested to develop widely and carry out routinely the intravenous anesthesia as an effective and safe technique in gynecological analgesia.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2006年第8期829-830,共2页
Medical Journal of Chinese People's Liberation Army
关键词
镇痛
产科
麻醉
硬膜外
镇痛
病人控制
analgesia, obstetrical
analgesia, epidural
analgesia, patient-controlled
