Zhou Rui, Peng Yanhua, Chen Xuemeng, Xiong Chao, Zhai Wenhu, Zhang Xianjie, Xia Leqiang, Zhou Yukai
Department of Anesthesiology, Deyang People's Hospital, Deyang City, Sichuan Province, People's Republic of China.
J Pain Res. 2023 Sep 27;16:3289-3296. doi: 10.2147/JPR.S424540. eCollection 2023.
Parturients suffer severe pain during the stages of labor, especially the first and second. Epidural anesthesia is an effective method to alleviate labor pain. L2-3, L3-4 and L4-5 spaces have been reported to be the recommendable puncture points owing to the adequate analgesia effect and high safety. However, the speed of pain alleviation via the three points has hardly been determined, which is of great importance to parturients. Thus, the aim of this study is to compare the onset time of parturients' painless uterine contraction after epidural labor analgesia through different puncture points.
It is a prospective, randomized, controlled, and subject- and assessor-blinded study. Totally, 150 subjects scheduled for vaginal delivery are going to be randomly assigned into the L2-3 and L3-4 group. Puncture point in L2-3 group is lumbar 2-3 space, while in L3-4 group it is lumbar 3-4 space. Analgesia initiation and maintenance are the same between the two groups. Primary outcome will be percentage of painless uterine contraction 15 min after epidural labor analgesia initiation. Secondary outcomes will be the sensory blocking level, motor blocking score, adverse effects of parturients, drug liquid consumption in unit interval, apgar score and degree of satisfaction of the parturients.
This study estimates the onset time of parturients' painless uterine contraction after epidural labor analgesia through L2-3 or L3-4 space. The results may provide a better choice to relieve labor pain as soon as possible.
产妇在分娩阶段会遭受剧烈疼痛，尤其是第一产程和第二产程。硬膜外麻醉是缓解分娩疼痛的有效方法。据报道，L2 - 3、L3 - 4和L4 - 5间隙因其镇痛效果良好且安全性高而成为推荐的穿刺点。然而，通过这三个穿刺点实现疼痛缓解的速度尚未确定，这对产妇至关重要。因此，本研究的目的是比较硬膜外分娩镇痛后不同穿刺点产妇无痛宫缩的起效时间。
这是一项前瞻性、随机、对照、受试者和评估者双盲的研究。总共150名计划进行阴道分娩的受试者将被随机分为L2 - 3组和L3 - 4组。L2 - 3组的穿刺点为腰2 - 3间隙，而L3 - 4组的穿刺点为腰3 - 4间隙。两组之间的镇痛起始和维持方法相同。主要结局指标将是硬膜外分娩镇痛开始后15分钟无痛宫缩的百分比。次要结局指标将包括感觉阻滞平面、运动阻滞评分、产妇的不良反应、单位时间内的药液消耗量、阿氏评分以及产妇的满意度。
本研究评估了硬膜外分娩镇痛通过L2 - 3或L3 - 4间隙后产妇无痛宫缩的起效时间。研究结果可能为尽快缓解分娩疼痛提供更好的选择。
