Harrison R F, Shore M, Woods T, Mathews G, Gardiner J, Unwin A
Acta Obstet Gynecol Scand. 1987;66(1):9-14. doi: 10.3109/00016348709092945.
Analgesic effect, labor outcome, safety and consumer satisfaction were compared in 170 primigravid women; 50 using TENS initially for pain relief, 20 using entonox, 50 pethidine + promazine and 50 lumbar epidural. 88% choosing epidural related it fully effective. 90% using entonox, 96% using TENS and 54% given pethidine + promazine found partial relief. 82% of patients given TENS and 80% given pethidine + promazine required additional analgesia. This was also needed by one of the 20 patients choosing entonox. Women using entonox alone had the shortest labors and women using lumbar epidural, the longest. Operative delivery was significantly more common in women receiving lumbar epidural. No significant inter-group differences were noted in cord pH or Apgar scores. Parturients and midwives both gave high consumer satisfaction ratings to all methods--except for pethidine + promazine, whose use must therefore be questioned. The analgesic efficacy of lumbar epidural outweighs any possible side effects. Entonox appears suited to those able to cope with the earlier part of labor, drug-free. Realization of the potential of TENS requires the design of machines specifically to cope with the quality of the pain of labor.
对170名初产妇的镇痛效果、分娩结局、安全性及消费者满意度进行了比较；50名最初使用经皮电刺激神经疗法（TENS）缓解疼痛，20名使用恩托诺克斯，50名使用哌替啶+异丙嗪，50名采用腰段硬膜外麻醉。选择硬膜外麻醉的患者中有88%认为其完全有效。使用恩托诺克斯的患者中有90%、使用TENS的患者中有96%以及使用哌替啶+异丙嗪的患者中有54%感觉疼痛部分缓解。使用TENS的患者中有82%以及使用哌替啶+异丙嗪的患者中有80%需要额外镇痛。选择恩托诺克斯的20名患者中有1名也需要额外镇痛。单独使用恩托诺克斯的女性产程最短，而使用腰段硬膜外麻醉的女性产程最长。接受腰段硬膜外麻醉的女性中，手术分娩明显更为常见。各组之间在脐动脉血pH值或阿氏评分方面未发现显著差异。产妇和助产士对所有方法的消费者满意度评分都很高——除了哌替啶+异丙嗪，因此其使用必须受到质疑。腰段硬膜外麻醉的镇痛效果超过任何可能的副作用。恩托诺克斯似乎适合那些能够在分娩早期无需药物应对的产妇。要实现TENS的潜力，需要专门设计机器来应对分娩疼痛的特点。
