Corli O, Grossi E, Roma G, Battagliarin G
Unità di Terapia Del Dolore, Ospedale V. Buzzi, Via Castelvetro n. 32, 20154 MilanItaly Divisione di Ostetricia e Ginecologia, Ospedale V. Buzzi, Via Castelvetro n. 32, 20154 MilanItaly Ciba-Geigy, Medical Department S.S. 233, km. 20.5, 21040 Origgio (VAItaly.
Pain. 1986 Jul;26(1):53-60. doi: 10.1016/0304-3959(86)90173-9.
Fifteen primiparous women underwent tocography during the second phase of the first stage of labour in order to evaluate the main characteristics of their uterine contractions (intensity, duration and pattern). At the end of each contraction, for a total of about 8 contractions per woman and an overall total of 125 tocographic curves, each woman was asked to make a subjective evaluation of the pain felt during that contraction using a 10 cm visual analogue scale (VAS). All the tocographic curves corresponding to the contractions studied were elaborated mathematically to determine the peak (intensity), base (duration) and area under the curve (AUC). Lastly, correlations between the mathematical parameters of the curves and corresponding VAS scores were sought. In the population a general positive correlation between the 3 main parameters of tocographic curves and the VAS score was demonstrated; the AUC and the peak tended to be better correlated with VAS than duration. Within-subject comparison showed the existence of a significant correlation with VAS score in 12/15 women as far as peaks are concerned, in 10/15 as far as AUC is concerned and in 0/15 women as regards duration. The findings support the concept that perceived labour pain depends in most of the women on the intensity and pattern of the uterine contractions. The possible clinical and experimental applications of this finding are discussed.
15名初产妇在第一产程第二期接受了宫缩图检查,以评估其子宫收缩的主要特征(强度、持续时间和模式)。在每次宫缩结束时,每位女性总共约有8次宫缩,总共125条宫缩图曲线,要求每位女性使用10厘米视觉模拟量表(VAS)对该次宫缩期间感受到的疼痛进行主观评估。对与所研究宫缩相对应的所有宫缩图曲线进行数学处理,以确定峰值(强度)、基线(持续时间)和曲线下面积(AUC)。最后,寻找曲线的数学参数与相应VAS评分之间的相关性。在该人群中,宫缩图曲线的3个主要参数与VAS评分之间呈现出总体正相关;AUC和峰值与VAS的相关性往往比持续时间更好。受试者内比较显示,就峰值而言,12/15的女性与VAS评分存在显著相关性;就AUC而言,10/15的女性存在显著相关性;而就持续时间而言,15名女性中无一例存在显著相关性。这些发现支持了这样一种观点,即大多数女性感觉到的分娩疼痛取决于子宫收缩的强度和模式。本文讨论了这一发现可能的临床和实验应用。