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在资源匮乏环境下静脉注射扑热息痛对分娩疼痛管理的疗效和安全性:一项随机临床试验。

Efficacy and safety of intravenous paracetamol in management of labour pains in a low resource setting: a randomized clinical trial.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia Univesity, Menoufia, Egypt.

出版信息

J Matern Fetal Neonatal Med. 2022 Dec;35(25):6320-6328. doi: 10.1080/14767058.2021.1911995. Epub 2021 Apr 26.

DOI:10.1080/14767058.2021.1911995
PMID:33902372
Abstract

OBJECTIVE

To assess the use of single dose of paracetamol intravenously in management of labour pains.

BACKGROUND

Pain during labour is a complex, subjective and multi-faceted physiological phenomenon that varies in intensity among women and is subjected to many social and cultural modifiers.

SUBJECTS AND METHODS

This randomized clinical study was conducted in Obstetrics and gynecology department from March 2019 to March 2020 including 96 primiparous women randomized into paracetamol group ( = 48) received 1000 mg of paracetamol IV infusion and pethidine group ( = 48) received 50 mg of pethidine given slowly IV. Primary outcome is the change of the intensity of perceived labor pain. Pain score was followed and recorded by visual analogue scale (VAS). Our study protocol was registered at ClinicalTrials.gov; NCT04744727.

RESULTS

VAS score was highly significant improved gradually after 30 min, 1, 2 and 3 h of paracetamol and pethidine taken compared at start study, but participants in paracetamol group had lower pain after 2 and 3 h (3.92 ± 1.42 and 5.69 ± 1.07) than those of the pethidine groups (4.42 ± 1.87 and 5.38 ± 1.34). Also, 2.1% of paracetamol group developed dizziness and 4.2% developed nausea and vomiting, while there was 29.2% of pethidine group developed dizziness and 37.5% developed nausea and vomiting.

CONCLUSIONS

Intravenous paracetamol as labour analgesia is effective, safe, inexpensive, available and with no maternal or fetal side effects as compared to Pethidine. Paracetamol needs to have more chance in comparison to other forms as a labour pain analgesia, especially in our communities.

摘要

目的

评估单次静脉注射扑热息痛在分娩疼痛管理中的应用。

背景

分娩疼痛是一种复杂的、主观的和多方面的生理现象,其强度在女性之间有所不同,并受到许多社会和文化因素的影响。

受试者和方法

这项随机临床研究于 2019 年 3 月至 2020 年 3 月在妇产科进行,纳入了 96 名初产妇,随机分为扑热息痛组(n=48),给予 1000mg 扑热息痛静脉输注,哌替啶组(n=48)给予 50mg 哌替啶缓慢静脉注射。主要结局是感知分娩疼痛强度的变化。疼痛评分通过视觉模拟量表(VAS)进行跟踪和记录。我们的研究方案在 ClinicalTrials.gov 上注册;NCT04744727。

结果

与研究开始时相比,扑热息痛和哌替啶分别在 30 分钟、1 小时、2 小时和 3 小时后 VAS 评分均显著逐渐改善,但扑热息痛组在 2 小时和 3 小时后疼痛较低(3.92±1.42 和 5.69±1.07),而哌替啶组则较高(4.42±1.87 和 5.38±1.34)。此外,扑热息痛组有 2.1%出现头晕,4.2%出现恶心和呕吐,而哌替啶组有 29.2%出现头晕,37.5%出现恶心和呕吐。

结论

与哌替啶相比,静脉注射扑热息痛作为分娩镇痛有效、安全、廉价、易得,且对母婴无副作用。与其他形式相比,扑热息痛需要有更多机会作为分娩疼痛的镇痛剂,尤其是在我们的社区中。

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