Rahmati Javad, Shahriari Mohammadali, Shahriari Ali, Nataj Masoomeh, Shabani Zeinab, Moodi Vihan
Aesthetic Department, Tehran University of Medical Sciences, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2021 Apr 17;11(2):e113350. doi: 10.5812/aapm.113350. eCollection 2021 Apr.
This study aimed to compare the analgesic effect of single-dose spinal versus epidural analgesia for labor pain to verify if applying a single dose spinal analgesia is an efficient technique for labor pain management as an alternative for epidural analgesia.
A total of 128 women in the active phase of labor were randomly allocated into two groups of spinal analgesia (n = 64) and epidural analgesia (n = 64). The latter received a bolus dose of 16 mL of 0.125% bupivacaine and 50 μg fentanyl and repeated 5 - 10 mL of bolus dose. The former received 2.5 mg hyperbaric bupivacaine plus 50μg fentanyl. Pain intensity was measured using the visual analog scale (VAS). The duration of analgesia, mode of delivery, the duration of labor, side effects, and maternal satisfaction were also compared.
There were no significant differences in the rate of cesarean section, duration of labor, postpartum hemorrhage, and the frequency of the fetal heart deceleration until 30 min after analgesia between the two groups. Measured pain after 30 (P = 0.0001) and 90 min (P = 0.01) was significantly lower in the spinal group than the epidural group. However, there was no significant difference between the spinal and epidural groups concerning the VAS scores at 150, 210, and 270 minutes. Maternal satisfaction was higher in the spinal group (P = 0.002). The mean duration of analgesia was longer in the spinal group than the epidural group (P = 0.0001).
According to the findings, single-dose spinal analgesia, compared to epidural analgesia, is a safe, fast, and efficient technique for labor analgesia, which can be easily performed. In addition, it provides a high satisfaction level in the parturient.
本研究旨在比较单次剂量脊髓镇痛与硬膜外镇痛用于分娩疼痛的镇痛效果，以验证单次剂量脊髓镇痛作为硬膜外镇痛的替代方法，是否是一种有效的分娩疼痛管理技术。
总共128名处于分娩活跃期的女性被随机分为两组，即脊髓镇痛组（n = 64）和硬膜外镇痛组（n = 64）。后者接受16毫升0.125%布比卡因和50微克芬太尼的推注剂量，并重复5 - 10毫升的推注剂量。前者接受2.5毫克高压布比卡因加50微克芬太尼。使用视觉模拟量表（VAS）测量疼痛强度。还比较了镇痛持续时间、分娩方式、产程、副作用和产妇满意度。
两组之间在剖宫产率、产程、产后出血以及镇痛后30分钟内胎儿心率减速频率方面无显著差异。脊髓组在镇痛后30分钟（P = 0.0001）和90分钟（P = 0.01）时测得的疼痛明显低于硬膜外组。然而，脊髓组和硬膜外组在150、210和270分钟时的VAS评分无显著差异。脊髓组的产妇满意度更高（P = 0.002）。脊髓组的平均镇痛持续时间比硬膜外组长（P = 0.0001）。
根据研究结果，与硬膜外镇痛相比，单次剂量脊髓镇痛是一种安全、快速且有效的分娩镇痛技术，易于实施。此外，它能为产妇提供较高的满意度。
