Keser Ivan, Straus Slavenka, Imamovic Denis, Mihalj Mirko
Department of Anesthesiology, General Hospital "Prim. Dr. Abdulah Nakaš", Sarajevo, BIH.
Clinic for Anesthesia and Reanimation, Clinical Center of the University of Sarajevo, Sarajevo, BIH.
Cureus. 2025 May 11;17(5):e83884. doi: 10.7759/cureus.83884. eCollection 2025 May.
Background In low- and middle-income countries, particularly during the COVID-19 pandemic, the availability of epidural analgesia for labor has been limited due to a shortage of anesthesiologists. As an alternative, single-shot spinal analgesia can offer effective pain relief during childbirth. Objective The objective of the study is to evaluate patient satisfaction with single-shot spinal analgesia provided during labor. Methods This descriptive cross-sectional study was conducted at the General Hospital Sarajevo over a two-year period. Fifty parturients received single-shot spinal analgesia during the active phase of labor (cervical dilatation ≥ 5 cm). The analgesic mixture included 0.5% levobupivacaine (0.5 mL), fentanyl (25 mcg), and 0.9% NaCl (1 mL). Pain intensity was assessed using a Visual Analog Scale (VAS) before the procedure, 10 minutes afterward, one hour after administration, and during delivery. Data were collected using a structured questionnaire. Results The average duration of labor pain prior to the procedure was four hours. Mean VAS scores were 9 before the procedure, 3 after 10 minutes, 1 after one hour, and 4 during delivery. Spinal analgesia lasted approximately 110 minutes. During this period, 66% of parturients delivered, while in 34%, the effect of analgesia ended before delivery. All patients expressed satisfaction with the analgesia received. Conclusion Single-shot spinal analgesia provided effective pain relief and high patient satisfaction, even among those who did not deliver during the period of analgesic effect. It offered parturients sufficient time to rest and actively participate in the final stage of labor.
背景 在低收入和中等收入国家，尤其是在新冠疫情期间，由于麻醉医生短缺，分娩时硬膜外镇痛的可及性受到限制。作为一种替代方法，单次脊髓麻醉可以在分娩期间提供有效的疼痛缓解。目的 本研究的目的是评估患者对分娩期间提供的单次脊髓麻醉的满意度。方法 这项描述性横断面研究在萨拉热窝总医院进行，为期两年。50名产妇在分娩活跃期（宫颈扩张≥5厘米）接受了单次脊髓麻醉。镇痛合剂包括0.5%左旋布比卡因（0.5毫升）、芬太尼（25微克）和0.9%氯化钠（1毫升）。在操作前、操作后10分钟、给药后1小时以及分娩期间，使用视觉模拟量表（VAS）评估疼痛强度。使用结构化问卷收集数据。结果 操作前分娩疼痛的平均持续时间为4小时。平均VAS评分在操作前为9分，10分钟后为3分，1小时后为1分，分娩期间为4分。脊髓麻醉持续约110分钟。在此期间，66%的产妇分娩，而34%的产妇镇痛效果在分娩前结束。所有患者对所接受的镇痛均表示满意。结论 单次脊髓麻醉即使在镇痛效果期内未分娩的患者中也能提供有效的疼痛缓解和较高的患者满意度。它为产妇提供了足够的时间休息并积极参与分娩的最后阶段。
