Obstetrics and Gynecology Department, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Bizkaia, Spain.
Clinical Epidemiology Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Bizkaia, Spain.
J Obstet Gynaecol. 2020 Aug;40(6):767-771. doi: 10.1080/01443615.2019.1647522. Epub 2019 Sep 5.
To assess the opinion and the level of satisfaction of patients concerning analgesia during external cephalic version (ECV), we present the results of a survey of 120 women undergoing ECV at term during a randomised controlled trial (July 2012 to February 2013) comparing remifentanil and nitrous oxide. Overall, 110 (91.7%) women said they would repeat the procedure and 111 (92.5%) that they would recommend it to another pregnant woman, with no significant differences by type of analgesia. The administration and sense of comfort were rated better in the remifentanil group ( < .01). In conclusion, the use of analgesia during ECV is associated with a high rate of willingness among women to repeat the procedure and recommend it to other pregnant women.Impact statement ECV is commonly a painful manoeuvre for the woman. This pain triggers maternal reactive abdominal muscle contraction and involuntary abdominal tensing, reducing the likelihood of successful version and causing some women to reject the technique. The use of analgesia during ECV is associated with a high rate of willingness among women to repeat the procedure and recommend it to other pregnant women. The sense of comfort during ECV was also significantly better in the remifentanil group, probably because of its greater analgesic power and greater comfort during its administration. ECV should be carried out under analgesia, when available, not only to decrease pain but also to encourage wider adoption of the technique and enable more women to benefit from it.
为了评估患者对外部 cephalic 版本（ECV）期间镇痛的意见和满意度，我们呈现了一项针对 120 名在随机对照试验中接受 ECV 的女性的调查结果，该试验比较了瑞芬太尼和一氧化二氮。总体而言，110 名（91.7%）女性表示愿意再次接受该手术，111 名（92.5%）女性表示愿意向其他孕妇推荐该手术，两种镇痛方式之间无显著差异。瑞芬太尼组的给药和舒适度评分更好（<0.01）。总之，在 ECV 期间使用镇痛与女性再次接受该手术和向其他孕妇推荐该手术的意愿率较高有关。
影响陈述 ECV 通常对女性来说是一种痛苦的操作。这种疼痛会引发产妇反应性腹肌收缩和不自觉的腹肌紧张，降低成功版本的可能性，并导致一些女性拒绝该技术。在 ECV 期间使用镇痛与女性再次接受该手术和向其他孕妇推荐该手术的意愿率较高有关。瑞芬太尼组在 ECV 期间的舒适度也明显更好，可能是因为它具有更强的镇痛作用和在给药过程中更舒适。如果有条件，ECV 应在镇痛下进行，不仅可以减轻疼痛，还可以鼓励更广泛地采用该技术，使更多女性受益。
