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[母亲对连续硬膜外产科麻醉的看法]

[Opinion of mothers on continuous peridural obstetrical anesthesia].

作者信息

Krumholz W, Müller H, Stoyanov M, Gerlach H, Bachmann-Mennenga B, Gerlach I, Hempelmann G

机构信息

Abteilung Anaesthesiologie und Operative Intensivmedizin, Klinikum der Justus-Liebig-Universität, Giessen.

出版信息

Reg Anaesth. 1987 Jul;10(3):77-81.

PMID:3659435
Abstract

The general opinion on epidural anesthesia in obstetrics may be adversely affected by recent public controversies about the mother's situation during childbirth in hospital, which nowadays is often considered to be a highly technological, impersonal, or "unnatural" procedure. This assumption led us to conduct an inquiry on maternal assessment of obstetric epidural anesthesia and its relation to the clinical and social history. The study included 113 parturients, who received epidural anesthesia (on-demand epidural injections of bupivacaine 0.25%) for vaginal delivery. Mothers were asked to answer certain questions about this regimen (e.g. analgetic efficacy; difficulties in deciding on this method; recommendations to other parturients; opinion of the role of epidural anesthesia in obstetrics; choice of analgesic regimen for future childbirth) 1 day after delivery and 2 months later. Additional social and historical factors (e.g. education; profession; family status; preceding pregnancy, childbirth or abortion; complications during pregnancy or childbirth; duration of parturition) were used to reveal relevant statistical correlations. Sixty-five percent of the patients considered pain relief by epidural anesthesia as "good" or even "very good" during the first inquiry immediately after childbirth. Women who had undergone prior interruptions of pregnancy were less satisfied, probably because of their rather ambiguous attitude towards motherhood. With regard to the choice of analgesic regimen for future childbirth (50% of the patients had made a definite decision to have epidural anesthesia under this condition), those women were especially reserved who had suffered from complications during pregnancy and disapproved of it in the future.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

近期公众对医院分娩时产妇情况的争议,可能会对产科硬膜外麻醉的普遍看法产生不利影响,如今分娩常被视为一项高科技、缺乏人情味或“非自然”的过程。这种假设促使我们对产妇对产科硬膜外麻醉的评估及其与临床和社会病史的关系进行调查。该研究纳入了113名接受硬膜外麻醉(按需硬膜外注射0.25%布比卡因)以进行阴道分娩的产妇。在产后1天和2个月后,要求产妇回答有关该方案的某些问题(例如镇痛效果;决定采用这种方法时遇到的困难;对其他产妇的建议;对硬膜外麻醉在产科中作用的看法;未来分娩镇痛方案的选择)。还利用了其他社会和历史因素(例如教育程度;职业;家庭状况;既往妊娠、分娩或流产情况;孕期或分娩期间的并发症;分娩时长)来揭示相关的统计相关性。65%的患者在产后立即进行的首次调查中认为硬膜外麻醉的疼痛缓解效果“良好”甚至“非常好”。有过妊娠中断经历的女性满意度较低,可能是因为她们对母亲身份的态度较为模糊。关于未来分娩镇痛方案的选择(50%的患者在此情况下已明确决定采用硬膜外麻醉),那些在孕期曾遭遇并发症且未来不希望出现此类情况的女性尤为谨慎。(摘要截选至250词)

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