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目的观察潜伏期低浓度局麻药椎管阻滞用于分娩镇痛对产程时间及母婴结局的影响。方法将200例孕产妇随机分为A组和B组各100例。A组在潜伏期进行低浓度局麻药椎管阻滞,B组在活跃期进行低浓度局麻药椎管阻滞,比较2组孕产妇产程时间及母婴结局的差异。结果 A组潜伏期明显短于B组,差异有统计学意义(P<0.05)。2组活跃期、第2产程时间及第3产程时间比较差异无统计学意义(P>0.05)。A组顺产率明显高于B组,差异有统计学意义(P<0.05)。2组分娩后1、5min新生儿Apgar评分及出血量比较差异无统计学意义(P>0.05)。经对2组孕产妇进行麻醉镇痛,2组均有恶心呕吐和皮肤瘙痒等不良反应出现,但发生率较低,A组中12例有轻微症状,B组中9例有不良反应表现。2组不良反应发生率比较差异无统计学意义(P>0.05),在生产过程中无低血压、产后尿潴留、呼吸抑制等不良反应出现。结论低浓度局麻药椎管阻滞用于潜伏期分娩镇痛可以缩短产程潜伏期时间,提高顺产率,值得临床应用。
Objective To observe the effect of low concentration local anesthetic spinal canal block during labor on labor time and maternal and infant outcome in labor analgesia. Methods 200 cases of pregnant women were randomly divided into A group and B group of 100 cases. A group in the incubation period of low concentrations of local anesthetic spinal block, B group in the active phase of spinal anesthesia with low concentrations of local anesthesia, the two groups of maternal labor time and maternal and infant outcomes were compared. Results The latency in group A was significantly shorter than that in group B, with a significant difference (P <0.05). There was no significant difference in the active stage, the second stage of labor and the third stage of labor between the two groups (P> 0.05). The birth rate of group A was significantly higher than that of group B, the difference was statistically significant (P <0.05). There was no significant difference in neonatal Apgar score and bleeding amount between the two groups after 1 and 5 min of delivery (P> 0.05). Nausea, vomiting and pruritus occurred in both groups. However, the incidence of nausea and vomiting was lower in both groups. Twelve patients in group A had mild symptoms and 9 patients in group B had adverse reactions. There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). No adverse reactions such as hypotension, postpartum urinary retention and respiratory depression occurred in the production process. Conclusion Low concentration of local anesthesia spinal block for labor analgesia during labor can shorten the incubation period of labor, improve the yield, is worth clinical application.