Department of OBG, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Department of Anaesthesiology and Critical Care, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Ann Afr Med. 2021 Oct-Dec;20(4):270-275. doi: 10.4103/aam.aam_59_20.
Alleviation of labour pain is known to improve maternal and fetal outcome. Combined Spinal-Epidural (CSE) analgesia is an excellent method.
In view of reports of its concerns on labour, this study was conducted to evaluate the progress of labour, obstetric outcome in cases with and without CSE analgesia, the maternal pain relief and fetomaternal adverse effects.
In this comparative study, 60 parturients were allocated into case and control groups of 30 each. CSE analgesia was administered utilizing 0.5 ml of 0.125% Levobupivacaine / 0.2% Ropivacaine with 2 mcg/ml fentanyl. Progress of labour was recorded in partogram including duration of labour, mode of delivery, pain relief - Visual Analogue Scale (VAS) score, development of motor block, maternal satisfaction and Apgar score. Data was analyzed by Descriptive and Inferential statistics.
Mean duration of first and second stage of labour among cases was 530±44.1 minutes, 61.5±12.7 minutes respectively and that of control was 526.6±64.9 minutes, 60±10.8 minutes respectively with no prolongation of labour P > 0.05. CSE analgesia did not alter the mode of delivery P=0.145 with rapid onset of pain relief. Apgar score was normal in both groups. Total 29 (97%) parturients experienced effective labour analgesia following CSE analgesia with VAS score 0. Maternal adverse effects included pruritus, transient initial motor blockade and post spinal headache.
CSE analgesia did not affect the duration of labour, mode of delivery with minimal fetomaternal adverse effects and provides rapid onset of pain relief . CSE analgesia can be considered for safe and effective labour analgesia.
减轻分娩疼痛已被证明可以改善母婴结局。联合硬膜外（CSE）镇痛是一种极好的方法。
鉴于其对分娩的担忧报告，本研究旨在评估有和没有 CSE 镇痛的情况下分娩进展、产科结局、产妇疼痛缓解和母婴不良影响。
在这项比较研究中，将 60 名产妇分配到病例组和对照组，每组 30 名。CSE 镇痛采用 0.5 毫升 0.125%左旋布比卡因/0.2%罗哌卡因加 2 微克/毫升芬太尼进行。产程进展记录在产程图中，包括产程持续时间、分娩方式、疼痛缓解-视觉模拟评分（VAS）评分、运动阻滞的发展、产妇满意度和阿普加评分。数据采用描述性和推断性统计进行分析。
病例组第一产程和第二产程的平均持续时间分别为 530±44.1 分钟和 61.5±12.7 分钟，对照组分别为 526.6±64.9 分钟和 60±10.8 分钟，产程无延长 P>0.05。CSE 镇痛并没有改变分娩方式 P=0.145，具有快速的疼痛缓解作用。两组的 Apgar 评分均正常。CSE 镇痛后，29 名（97%）产妇经历了有效的分娩镇痛，VAS 评分为 0。产妇的不良反应包括瘙痒、短暂的初始运动阻滞和脊麻后头痛。
CSE 镇痛不会影响产程持续时间和分娩方式，对母婴的不良影响最小，并提供快速的疼痛缓解。CSE 镇痛可作为安全有效的分娩镇痛方法。
