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皮内注射无菌水对分娩腰痛妇女的影响:一项随机、对照、临床试验。

Effects of Intradermal Sterile Water Injections in Women with Low Back Pain in Labor: A Randomized, Controlled, Clinical Trial.

机构信息

Department of Maternity and Gynecology Nursing, Beykent University School of Medicine, İstanbul, Turkey.

Department of Maternity and Gynecology Nursing, Marmara University School of Medicine, İstanbul, Turkey.

出版信息

Balkan Med J. 2018 Mar 15;35(2):148-154. doi: 10.4274/balkanmedj.2016.0879. Epub 2017 Oct 26.

Abstract

BACKGROUND

In addition to the pain caused byuterine contractions during labour, continuous and severe back pain is observed in 33% of women. Several pharmacological and nonpharmacological methods are available for managing this pain. Sterile water injection is considered as alternative method for nonpharmacological pain management.

AIMS

To assess the satisfaction level and effectiveness of sterile water injection for back pain among women in labour.

STUDY DESIGN

Randomized controlled trial.

METHODS

A total of 168 term, healthy women with labour pain and severe back pain were randomized into the sterile water injection (study) and dry injection (placebo) groups. Injections were applied to the rhombus of Michaelis in the sacral area. Pain scores were assessed at 10, 30, 60, 120, and 180 min using a visual analogue scale. Additionally, the need for epidural analgesia, Apgar score, mode of delivery, time of delivery, maternal satisfaction, and breastfeeding score were assessed.

RESULTS

The mean back pain scores at 30 min after injections were significantly lower in the study group (study group: 31.66±11.38; placebo: 75±18.26, p<0.01). The mean decrease in pain scores after 30 min according to baseline was significantly higher in the study group (study group: 54.82±7.81; placebo: 13.33±12.05, p<0.01). The need for epidural analgesia, time of delivery, mode of delivery, and Apgar and breastfeeding scores were similar in both groups. Maternal satisfaction from the analgesic effect was significantly higher in the study group (study group: 84.5%; placebo: 35.7%, p<0.01).

CONCLUSION

The application of sterile water injection is effective for relieving back pain in the first stage of labour and has a sufficient satisfaction level among women.

摘要

背景

除分娩时子宫收缩引起的疼痛外,33%的女性还会持续出现严重的背痛。有多种药理学和非药理学方法可用于缓解这种疼痛。无菌水注射被认为是一种替代的非药理学疼痛管理方法。

目的

评估无菌水注射治疗分娩时背痛的满意度和有效性。

研究设计

随机对照试验。

方法

共有 168 名足月、健康、有分娩疼痛和严重背痛的妇女被随机分为无菌水注射(研究)组和干燥注射(安慰剂)组。在骶骨区 Michaelis 菱形处进行注射。使用视觉模拟评分法在 10、30、60、120 和 180 分钟时评估疼痛评分。此外,还评估了硬膜外镇痛的需求、阿普加评分、分娩方式、分娩时间、产妇满意度和母乳喂养评分。

结果

注射后 30 分钟时,研究组的平均背痛评分明显较低(研究组:31.66±11.38;安慰剂组:75±18.26,p<0.01)。与基线相比,注射后 30 分钟时疼痛评分的平均下降幅度在研究组中明显更高(研究组:54.82±7.81;安慰剂组:13.33±12.05,p<0.01)。两组的硬膜外镇痛需求、分娩时间、分娩方式以及阿普加和母乳喂养评分相似。研究组产妇对镇痛效果的满意度明显更高(研究组:84.5%;安慰剂组:35.7%,p<0.01)。

结论

无菌水注射在缓解第一产程背痛方面有效,且在女性中具有足够的满意度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ade/5863252/7db63d522db9/BMJ-35-148-g8.jpg

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