El-Refaie Tamer A, El-Said Mourad M, Shoukry Aktham A, Khafagy Soha M, El-Din Adel S, Badawy Montaha M
Departments of Obstetrics and Gynecology, Ain Shams University Maternity Hospital, Cairo, Egypt.
J Obstet Gynaecol Res. 2012 Feb;38(2):383-9. doi: 10.1111/j.1447-0756.2011.01719.x. Epub 2012 Jan 10.
The aim of this study was to evaluate the effectiveness of meperidine, administered during the first stage of labor in patients with uterine dystocia, on the duration of labor and neonatal acid-base status at birth.
We randomly assigned 240 nulliparous women with a singleton pregnancy at term who were diagnosed with uterine dystocia in labor at 4-6-cm cervical dilatation to receive either a single dose of 50 mg meperidine in 10 mL of saline (slow intravenous injection over 2 min) or 10 mL of isotonic saline (control group). The primary outcome measures were duration of labor (from the time of beginning of the intervention to the time of the expulsion of the fetal head) and umbilical cord arterial acid-base status.
The evidence revealed no statistically significant difference between the two groups in length of labor (188.2 ± 92.3 min in the meperidine group compared to 205.4 ± 96.1 min in the placebo group, P = 0.159). The pH of the umbilical cord arterial samples was lower in the meperidine group than in the control group, although the difference was not statistically significant (P = 0.089).
Because of the absence of any beneficial effect of meperidine on uterine dystocia, its use in labor should be limited to pain relief in the absence of epidural analgesia.
本研究旨在评估哌替啶在子宫收缩乏力患者第一产程中应用对产程及新生儿出生时酸碱状态的有效性。
我们将240名单胎足月妊娠、宫颈扩张4 - 6厘米时诊断为子宫收缩乏力的初产妇随机分为两组，一组接受10毫升生理盐水加50毫克哌替啶单剂量（2分钟内缓慢静脉注射），另一组接受10毫升等渗生理盐水（对照组）。主要观察指标为产程（从干预开始至胎头娩出时间）及脐动脉酸碱状态。
证据显示两组产程长度无统计学显著差异（哌替啶组为188.2±92.3分钟，安慰剂组为205.4±96.1分钟，P = 0.159）。哌替啶组脐动脉样本的pH值低于对照组，尽管差异无统计学意义（P = 0.089）。
由于哌替啶对子宫收缩乏力无任何有益作用，其在分娩中的应用应限于无硬膜外镇痛时的止痛。
