Shokrpour Maryam, Reza Parisa Pour Seyed, Sharifi Mehrzad, Kamali Alireza
Department of Gynecology, Arak University of Medical Sciences, Arak, Iran.
Department of Surgery, Arak University of Medical Sciences, Arak, Iran.
Med Arch. 2019 Dec;73(6):399-403. doi: 10.5455/medarh.2019.73.399-403.
The labor pain is probably the most severe pain a mother experiences in her lifetime and is usually severe and prolonged in women with pregnancy.
To evaluate the effects of labor epidural and spinal analgesia on the incidence of cesarean section in painless delivery.
This randomized clinical trial was conducted on pregnant women aged 37-42 weeks of pregnancy. Female candidates for painless labor were divided into two groups: Epidural Analgesia (EA) and Spinal Analgesia (SA). Patients in the labor epidural group underwent analgesia using marcaine and fentanyl and after fully assuring the normal hemodynamic status of the mother and fetal hearth rate (FHR), labor spinal analgesia was used for other group.
The average age of mothers was 27.5 years, their mean gestational age was 39 weeks and their mean weight was determined to be 72 kg. Frequency of cesarean delivery in mothers was found as 12.9%. Significantly, the incidence of cesarean section in the labor epidural analgesia group was higher than the labor spinal analgesia group (P = 0.02). In addition, the mean second phase of delivery in the labor epidural analgesia group was significantly higher than the labor spinal analgesia group (P = 0.03). There was no significant in 1st and 5th min Apgar scores between groups in infants (8.6 and 9.6, respectively).
Labor epidural analgesia and labor spinal analgesia result in a significant reduction in pain due to normal delivery. Due to the similarity of Apgar and arterial blood gas (ABG) in neonates, labor epidural analgesia may serve as an alternative in childbirth delivery.
分娩疼痛可能是母亲一生中经历的最剧烈的疼痛,在孕妇中通常较为严重且持续时间长。
评估分娩硬膜外镇痛和脊髓镇痛对无痛分娩中剖宫产发生率的影响。
本随机临床试验针对妊娠37 - 42周的孕妇进行。无痛分娩的女性候选者分为两组:硬膜外镇痛(EA)组和脊髓镇痛(SA)组。分娩硬膜外组患者使用布比卡因和芬太尼进行镇痛,在充分确保母亲正常血流动力学状态和胎儿心率(FHR)后,另一组使用分娩脊髓镇痛。
母亲的平均年龄为27.5岁,平均孕周为39周,平均体重确定为72千克。母亲剖宫产的发生率为12.9%。值得注意的是,分娩硬膜外镇痛组的剖宫产发生率高于分娩脊髓镇痛组(P = 0.02)。此外,分娩硬膜外镇痛组的平均第二产程明显高于分娩脊髓镇痛组(P = 0.03)。两组婴儿出生后1分钟和5分钟的阿氏评分无显著差异(分别为8.6和9.6)。
分娩硬膜外镇痛和分娩脊髓镇痛可显著减轻正常分娩引起的疼痛。由于新生儿阿氏评分和动脉血气(ABG)相似,分娩硬膜外镇痛可作为分娩时的一种替代方法。