Vandermeulen E P, Van Aken H, Vertommen J D
Department of Anesthesiology, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium.
Eur J Obstet Gynecol Reprod Biol. 1995 May;59 Suppl:S47-54. doi: 10.1016/0028-2243(95)02063-x.
To determine whether the use of patient-controlled epidural analgesia (PCEA) versus intermittent injections (CIT) resulted in local anesthetic dose reduction.
PCEA and CIT using a mixture of 0.125% bupivacaine with sufentanil 1 or 0.75 microgram/ml were compared in 60 and 195 parturients, respectively. Assessments included pain scores, local anesthetic consumption, degree of motor blockade, type of delivery and neonatal outcome. Statistical analysis was done using Student's t test and Chi-squares.
PCEA and CIT provided effective analgesia during labor and delivery. A higher dose of opioid significantly reduced the use of local anesthetic solution in PCEA-patients. There was no difference in motor blockade, type of delivery and neonatal outcome.
Patient-controlled epidural analgesia is an effective, safe and acceptable alternative to conventional intermittent epidural injections for pain relief during labor and delivery.
确定使用患者自控硬膜外镇痛（PCEA）与间断注射（CIT）相比是否能减少局部麻醉药用量。
分别对60例和195例产妇比较使用0.125%布比卡因与1或0.75微克/毫升舒芬太尼混合液的PCEA和CIT。评估内容包括疼痛评分、局部麻醉药消耗量、运动阻滞程度、分娩方式及新生儿结局。采用学生t检验和卡方检验进行统计学分析。
PCEA和CIT在分娩过程中均提供了有效的镇痛。较高剂量的阿片类药物显著减少了PCEA患者局部麻醉药溶液的使用量。运动阻滞、分娩方式和新生儿结局方面无差异。
对于分娩期间的疼痛缓解，患者自控硬膜外镇痛是传统间断硬膜外注射的一种有效、安全且可接受的替代方法。
