Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institute, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2013 Mar;92(3):306-11. doi: 10.1111/aogs.12067. Epub 2013 Feb 15.
To investigate the pain relief used in association with vacuum extraction assisted deliveries and to identify risk factors for not receiving pain relief during the procedure.
Retrospective birth register study.
Nationwide study in Sweden.
The study population consisted of all women (n = 62 568) with a singleton pregnancy who gave birth in gestational weeks 37(+0) to 41(+6) between 1999 and 2008 and were delivered by vacuum extraction.
Register study with data from the Swedish Medical Birth Register.
Epidural blockade, spinal blockade, pudendal nerve blockade, infiltration of the perineum, no pain relief.
In all, 32.4% primiparas and 51.4% multiparas who had a vacuum-assisted delivery had this without potent pain relief such as epidural blockade, spinal blockade or pudendal nerve block. When infiltration was added as a method for pain relief, 18% were still delivered without pain relief. Multiparas were more likely than primiparas to be delivered without potent pain relief, odds ratio (OR) 2.29 95% confidence interval (CI) (2.20-2.38). Compared with women delivered by vacuum extraction due to prolonged labor, those with signs of fetal distress were more likely to be delivered without potent pain relief (OR) 1.74, 95% (CI) (1.68-1.81).
A considerable number of women are delivered by vacuum extraction without pain relief. The high proportion might reflect that clinical staff do not always consider pain relief to be of high priority in vacuum extraction deliveries or that they fear impaired pushing forces.
调查真空吸引辅助分娩中使用的止痛方法，并确定分娩过程中未接受止痛的风险因素。
回顾性出生登记研究。
瑞典全国性研究。
研究人群由 1999 年至 2008 年间妊娠 37（+0）周至 41（+6）周且单胎妊娠的所有女性（n=62568）组成，分娩方式为真空吸引。
采用瑞典医疗出生登记处的数据进行登记研究。
硬膜外阻滞、脊髓阻滞、阴部神经阻滞、会阴浸润、无止痛。
在所有接受真空辅助分娩的初产妇和经产妇中，32.4%和 51.4%的产妇没有强效止痛措施，如硬膜外阻滞、脊髓阻滞或阴部神经阻滞。当浸润被用作止痛方法时，仍有 18%的产妇没有止痛。与初产妇相比，经产妇更有可能在没有强效止痛的情况下分娩，优势比（OR）2.29 95%置信区间（CI）（2.20-2.38）。与因产程延长而接受真空吸引分娩的妇女相比，有胎儿窘迫迹象的妇女更有可能在没有强效止痛的情况下分娩（OR）1.74，95%置信区间（CI）（1.68-1.81）。
相当多的妇女在接受真空吸引分娩时没有得到止痛。这一高比例可能反映了临床工作人员并不总是认为在真空吸引分娩中止痛是优先事项，或者他们担心会削弱推动力量。
