硬膜外镇痛与腰麻-硬膜外联合镇痛用于分娩的比较：一项对6497例病例的回顾性研究
Comparison of epidural analgesia with combined spinal-epidural analgesia for labor: a retrospective study of 6497 cases.
作者信息
Miro M, Guasch E, Gilsanz F
机构信息
Department of Obstetric Anesthesia, Madrid Autónoma University, Hospital Universitario Maternal La Paz, Madrid, Spain.
出版信息
Int J Obstet Anesth. 2008 Jan;17(1):15-9. doi: 10.1016/j.ijoa.2007.07.003.
BACKGROUND
Combined spinal-epidural analgesia provides rapid-onset analgesia with minimal motor block, but it is a more invasive technique than epidural analgesia and the risk of complications may be increased. This study compared the safety and effect on delivery of combined spinal-epidural and epidural analgesia in labor.
METHODS
A retrospective observational study was performed. Data were collected from 6497 women who received regional analgesia in our tertiary hospital in 2005. The incidence of complications during labor and the day after delivery was compared. The effect on labor outcome with both techniques was also assessed.
RESULTS
1964 received combined spinal-epidural (30.2%) and 4533 epidural analgesia (69.8%). Quality of analgesia was better in the combined spinal-epidural group. Labor outcome was similar in the two groups. Pruritus, paresthesia and back pain were more frequent in the combined spinal-epidural group. No differences were observed in the incidence of accidental dural puncture or post dural puncture headache.
CONCLUSIONS
We found that epidural and combined spinal-epidural analgesia were comparable in terms of safety, and had a similar effect on delivery type.
背景
腰麻 - 硬膜外联合镇痛起效迅速且运动阻滞轻微，但它是一种比硬膜外镇痛侵入性更强的技术，并发症风险可能增加。本研究比较了腰麻 - 硬膜外联合镇痛与硬膜外镇痛在分娩中的安全性及对分娩的影响。
方法
进行一项回顾性观察研究。收集了2005年在我们三级医院接受区域镇痛的6497名女性的数据。比较了分娩期间及产后一天并发症的发生率。还评估了两种技术对分娩结局的影响。
结果
1964名接受腰麻 - 硬膜外联合镇痛（30.2%），4533名接受硬膜外镇痛（69.8%）。腰麻 - 硬膜外联合镇痛组的镇痛质量更好。两组的分娩结局相似。腰麻 - 硬膜外联合镇痛组瘙痒、感觉异常和背痛更常见。意外硬膜穿破或硬膜穿破后头痛的发生率未观察到差异。
结论
我们发现硬膜外镇痛和腰麻 - 硬膜外联合镇痛在安全性方面相当，对分娩类型的影响相似。
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