Ji Xianghong, Qi Hong, Liu Aimin
Department of Obstetrics and Gynecology, Qing Dao Municipal Hospital, Qingdao 266011, China.
Zhonghua Fu Chan Ke Za Zhi. 2002 Jul;37(7):398-401.
To study the pain relief effectiveness of the combined spinal-epidural analgesia (CSEA) and the inhalation of nitrous oxide, and the influences on the mothers and infants.
The 300 cases of pregnant women were randomly divided into 3 groups: CSEA group, nitrous oxide group and control group. The nitrous oxide group was that pregnant women inhaled nitrous oxide premixed with oxygen (50%:50%), the pregnant women of the CSEA group were injected fentanyl and bupivacaine in the subarachnoid and epidural space, analgesic was not used in the control group. The degree of labor pain, duration of the labor, way of delivery, bleeding volume, rate of anoxia of newborn, blood gas analysis to maternal radius artery and fetal umbilical blood among 3 groups were observed.
The effect for analgesia labor of the CSEA group was much better than that of the nitrous oxide group (P < 0.01). In the first stage of labor and total stage of labor, the CSEA group was shorter than the others (P < 0.05), but there was no difference between the nitrous oxide group and the control group (P > 0.05). In the second stage of labor, the 3 groups were alike to each other. The bleeding volume of caesarean section (373 +/- 77) ml in the nitrous oxide group was much more than the other 2 groups, there was no difference between the CSEA group (259 +/- 78) ml and the control group (239 +/- 89) ml. The rate of obstetric forceps of CSEA group was higher than the control group (P < 0.01), and the rate of caesarean section of the nitrous oxide group was much higher than the CSEA group. The blood gas analysis to maternal radius artery and fetal umbilical blood and the rate of anoxia of newborn of 3 groups revealed no significant difference.
The effectiveness of the combined spinal-epidural analgesia CSEA for analgesia labor is confirmed and has rarely side-effect, and it can be the first choice, and the inhalation of nitrous oxide can safely provide effective labor analgesia, too.
研究腰麻-硬膜外联合镇痛（CSEA）与氧化亚氮吸入用于分娩镇痛的效果及对母婴的影响。
将300例孕妇随机分为3组：CSEA组、氧化亚氮组和对照组。氧化亚氮组孕妇吸入氧气与氧化亚氮预混气体（50%:50%），CSEA组孕妇于蛛网膜下腔和硬膜外腔注入芬太尼和布比卡因，对照组不采取镇痛措施。观察3组产妇的产痛程度、产程、分娩方式、出血量、新生儿窒息率以及产妇桡动脉和胎儿脐血血气分析情况。
CSEA组分娩镇痛效果明显优于氧化亚氮组（P<0.01）。第一产程及总产程中，CSEA组短于其他两组（P<0.05），但氧化亚氮组与对照组无差异（P>0.05）。第二产程中，3组无差异。氧化亚氮组剖宫产出血量（373±77）ml，明显多于其他两组，CSEA组（259±78）ml与对照组（239±89）ml无差异。CSEA组产钳助产率高于对照组（P<0.01），氧化亚氮组剖宫产率高于CSEA组。3组产妇桡动脉和胎儿脐血血气分析及新生儿窒息率无明显差异。
腰麻-硬膜外联合镇痛（CSEA）用于分娩镇痛效果确切，副作用少，可作为首选，氧化亚氮吸入也可安全有效地用于分娩镇痛。
