Cutura Nedo, Soldo Vesna, Curković Aleksandar, Tomović Branko, Mitrović Tanja
Ginekolosko-akuserska klinika Narodni front Beograd, Srbija.
Vojnosanit Pregl. 2009 Apr;66(4):319-22. doi: 10.2298/vsp0904319c.
BACKGROUND/AIM: Epidural anaesthesia (EA) is the most efficient method of pain reduction and its total elimination during delivery. The aim of this study was to establish an influence of EA on the first and the second part of delivery process, frequency of vacuum extractor and forceps appliance, and the effect of EA on the newborn.
A total of 360 patients with EA were analysed at delivery and 1130 controls without EA. Both groups had vaginal delivery. In both groups deliveries were stimulated by 10 IU of oxytocin in 500 mL of crystalloid solvent, with 15-20 drops per minute. As anaesthetic, Bupivacain (0.25% or 0.125%) was used by the 18 G catheters Braun and Wigon. Level of application was L2-L3 part of spine.
The results of this study indicate that deliveries with EA were shorter in duration, but also had much more vacuum extractor and forceps appliance (over 2.5 times) than those without EA. Apgar score was significantly higher in the experimental group with multiple deliveries. However, there was no significant deference between avarage Apgar score of newborns of patients with EA and that of newborns of patients without EA.
Application of EA decreases duration of delivery, and has no any adverse effects on newborns.
背景/目的:硬膜外麻醉(EA)是分娩过程中减轻疼痛及完全消除疼痛的最有效方法。本研究的目的是确定EA对分娩第一和第二产程、真空吸引器和产钳使用频率的影响,以及EA对新生儿的影响。
共分析了360例分娩时接受EA的患者和1130例未接受EA的对照者。两组均为阴道分娩。两组均用500ml晶体溶剂中加入10IU催产素进行引产,每分钟15 - 20滴。作为麻醉剂,使用Braun和Wigon的18G导管注入布比卡因(0.25%或0.125%)。穿刺部位为脊柱L2 - L3节段。
本研究结果表明,接受EA的分娩持续时间较短,但与未接受EA的分娩相比,真空吸引器和产钳的使用频率要高得多(超过2.5倍)。多次分娩的实验组阿氏评分显著更高。然而,接受EA的患者新生儿平均阿氏评分与未接受EA的患者新生儿平均阿氏评分之间无显著差异。
EA的应用可缩短分娩时间,且对新生儿无任何不良影响。