Han Soo Jung, Kim Jeung Im, Kim Myo Jin
Soon Chun Hyang University Buchon Hospital, Buchon, Korea.
Korean J Women Health Nurs. 2012 Jun;18(2):126-134. doi: 10.4069/kjwhn.2012.18.2.126. Epub 2012 Jun 30.
This research was done to compare obstetric pain, anxiety and cervical dilatation between an epidural analgesia group and a control group.
Participants were assigned to the experimental or control group depending on their decisions for pain relief. Subjective / objective obstetric pain, anxiety level and cervical dilatation were measured and ANOVA was used for comparison of groups and paired t-test to make pre-post comparisons.
Homogeneity of pain, anxiety and cervical dilatation were assessed at the latent phase. Cervical dilatation was larger in the control group than the experimental group, at both the active and the transitional phase (F=22.9, p<.001; F=39.9, p<.001 respectively). The degree of pain and anxiety were not significantly different between the groups. Within the experimental group, subjective / objective pain and anxiety level were significantly lower postanalgesia compared to pre-analgesia in the active phase. All variables, except for sweating in the objective pain measurement, changed significantly at the transient phase.
The results of this evidence-based research indicate that epidural analgesia while effective in relieving pain and anxiety may have an adverse effect on the cervix during labor stage I. Epidural analgesia should be used carefully during cervical dilatation in labor stage I.
本研究旨在比较硬膜外镇痛组和对照组之间的产科疼痛、焦虑及宫颈扩张情况。
根据参与者对疼痛缓解的决定将其分配至实验组或对照组。测量主观/客观产科疼痛、焦虑水平及宫颈扩张情况，采用方差分析进行组间比较，配对t检验进行前后比较。
在潜伏期评估疼痛、焦虑及宫颈扩张的同质性。在活跃期和过渡期，对照组的宫颈扩张均大于实验组（分别为F=22.9，p<.001；F=39.9，p<.001）。两组间疼痛程度和焦虑程度无显著差异。在实验组内，活跃期镇痛后主观/客观疼痛及焦虑水平均显著低于镇痛前。除客观疼痛测量中的出汗情况外，所有变量在过渡期均有显著变化。
这项循证研究的结果表明，硬膜外镇痛虽能有效缓解疼痛和焦虑，但可能在第一产程对宫颈产生不良影响。在第一产程宫颈扩张期应谨慎使用硬膜外镇痛。
