Griffin R P, Reynolds F
Division of Anaesthetics, UMDS, St Thomas' Hospital, London.
Anaesthesia. 1995 Feb;50(2):151-6. doi: 10.1111/j.1365-2044.1995.tb15101.x.
The effect of analgesia on the incidence of hypoxaemia was assessed in an unrandomised trial in 51 parturients from the last hour of the first stage of labour until delivery. Women were retrospectively divided into four groups: no analgesia, pethidine with intermittent Entonox, extradural bupivacaine (either infusion of 0.125% or top-ups of 10 ml of 0.25%): and extradural infusion of 0.1% bupivacaine with 2 micrograms.ml-1 fentanyl. The lowest median incidence of desaturation (SpO2 < 94%) was in the extradural bupivacaine group: 0 min.h-1 in the last hour of the first stage and 0.1 min.h-1 in the second stage. The incidence was significantly lower than in the pethidine/Entonox group (1.4 min.h-1) in the last hour of the first stage (p < 0.001) and the extradural bupivacaine/fentanyl group (0.9 min.h-1) and no analgesia group (3 min.h-1) in the second stage (p < 0.05 in both cases). There was no correlation between maternal oxygenation during the second stage and measures of neonatal outcome including Apgar score and umbilical artery and vein blood gases.
在一项非随机试验中，对51名产妇从第一产程最后一小时直至分娩期间镇痛对低氧血症发生率的影响进行了评估。这些女性被回顾性地分为四组：未镇痛组、哌替啶联合间歇性恩托诺克斯组、硬膜外布比卡因组（0.125%持续输注或10 ml 0.25%追加）以及硬膜外输注0.1%布比卡因加2微克/毫升芬太尼组。去饱和（脉搏血氧饱和度<94%）的最低中位发生率出现在硬膜外布比卡因组：第一产程最后一小时为0分钟/小时，第二产程为0.1分钟/小时。该发生率在第一产程最后一小时显著低于哌替啶/恩托诺克斯组（1.4分钟/小时，p<0.001），在第二产程显著低于硬膜外布比卡因/芬太尼组（0.9分钟/小时）和未镇痛组（3分钟/小时，两种情况p均<0.05）。第二产程中母体氧合与包括阿氏评分、脐动脉和脐静脉血气在内的新生儿结局指标之间无相关性。
