Shafeinia Amineh, Rahimi Maryam, Nikoubakht Nasim, Ghaed Mohammad Ali
Department of Anesthesiology, School of Medicine, Shahid Akbar-Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2022 Nov 29;12(6):e121297. doi: 10.5812/aapm-121297. eCollection 2022 Dec.
Delivery pain is the most unbearable pain and can be relieved with intrathecal opioids. This study aimed to investigate the effect of intrathecal sufentanil for painless delivery on labor progress and neonatal outcomes in pregnant women.
This was a single-arm observational cohort study on 1055 pregnant women candidates for vaginal delivery with spinal analgesia referred to the Akbarabadi Hospital. First, 0.1 µg/kg of intrathecal sufentanil was used, and maternal blood pressure and maternal and fetal heart rates were recorded after analgesia. During delivery, the mothers were monitored for nausea, pruritus, motor block, apnea, urinary retention, or the possibility of an emergency cesarean section. The duration of the analgesia, the duration of the second stages of labor, and the mother's pain scores were recorded based on the Visual Analogue Scale (VAS). 1- and 5-minute Apgar scores and arterial blood gas (ABG) of the umbilical cord were also recorded.
The most common station was -3 for 723 women, followed by -2 for 229 women. Fifty-two women underwent cesarean section, and fetal distress was the most common reason for cesarean section (57.7%). The mean time for initiating analgesia was 5.93 ± 2.87 minutes, and the mean visual analog scale was 1.08 ± 0.16. The mean Apgar was 9.0 ± 0.47; the mean weight at birth was 2917.39 ± 449.90 gr; PH was 7.31 ± 2.03; HCO was 22.67 ± 3.08mEq/liter, and PaCo was 43.36 ± 7.06 mmHg. Regarding complications, the patients just developed itching (n = 78), and hypotension, bradycardia, apnea, and decreased consciousness were overlooked.
Intrathecal sufentanil is safe and efficient in painless delivery, resulting in normal Apgar and normal PH with no specific side-effect.
分娩疼痛是最难以忍受的疼痛，鞘内注射阿片类药物可缓解这种疼痛。本研究旨在探讨鞘内注射舒芬太尼用于无痛分娩对孕妇产程及新生儿结局的影响。
这是一项单臂观察性队列研究，对1055名转诊至阿克巴拉巴迪医院行脊髓镇痛的阴道分娩候选孕妇进行研究。首先，使用0.1μg/kg鞘内舒芬太尼，镇痛后记录产妇血压及母婴心率。分娩期间，监测产妇是否出现恶心、瘙痒、运动阻滞、呼吸暂停、尿潴留或紧急剖宫产的可能性。根据视觉模拟评分法（VAS）记录镇痛持续时间、第二产程持续时间及产妇疼痛评分。还记录1分钟和5分钟阿氏评分及脐带动脉血气（ABG）。
723名女性最常见的胎位为-3，其次229名女性为-2。52名女性接受了剖宫产，胎儿窘迫是剖宫产最常见的原因（57.7%）。开始镇痛的平均时间为5.93±2.87分钟，平均视觉模拟评分为1.08±0.16。平均阿氏评分为9.0±0.47；出生时平均体重为2917.39±449.90克；pH值为7.31±2.03；碳酸氢根为22.67±3.08mEq/升，二氧化碳分压为43.36±7.06mmHg。关于并发症，患者仅出现瘙痒（n = 78），未发现低血压、心动过缓、呼吸暂停和意识下降。
鞘内注射舒芬太尼用于无痛分娩安全有效，可使阿氏评分和pH值正常，且无特定副作用。
