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[挪威医院的产科镇痛]

[Obstetric analgesia in Norwegian hospitals].

作者信息

Dahl V, Hagen I E, Raeder J C

机构信息

Anestesiavdelingen Ullevål sykehus, Oslo.

出版信息

Tidsskr Nor Laegeforen. 1998 Apr 30;118(11):1693-6.

PMID:9621757
Abstract

We report the results of a questionnaire sent to anaesthetists and midwives on the use of obstetric analgesia and anaesthesia in Norwegian hospitals in 1996. 95% of the 49 hospitals involved responded to the questionnaire, representing a total of 56,884 births. The use of epidural analgesia in labour varied from 0 to 25% in the different hospitals with a mean value of 15%. Epidural analgesia was much more widely used in university and regional hospitals than in local hospitals (p < 0.001). Five of the local hospitals did not offer epidural analgesia during labour at all. The combination of low-dose local anaesthetic and an opioid (either sufentanil or fentanyl) had not been introduced in nine of the hospitals (20%). The optimal use of epidural analgesia to relieve labour pain was judged to be more frequent by the anaesthetists than by the midwives (19% versus 11%, p < 0.01). In response to what factors limited the frequency of epidural analgesia, the anaesthetists specified factors related to the attitude of the midwife, and the midwives specified factors related to the anaesthetist. Only five of the hospitals provided written information on the various analgesic methods that could be employed during labour. The majority of midwives considered the analgesic methods employed on their maternity ward to be good or excellent. The frequency of Caesarean section was 12%; spinal anaesthesia was used in 55%, epidural anaesthesia in 17%, and general anaesthesia in 28% of the cases.

摘要

我们报告了1996年向挪威医院的麻醉师和助产士发送的一份关于产科镇痛和麻醉使用情况的调查问卷结果。参与调查的49家医院中有95%对问卷做出了回复,代表了总共56884例分娩。不同医院分娩时硬膜外镇痛的使用率从0%到25%不等,平均值为15%。硬膜外镇痛在大学医院和地区医院的使用比在当地医院广泛得多(p<0.001)。五家当地医院在分娩时根本不提供硬膜外镇痛。九家医院(20%)尚未采用低剂量局部麻醉药与阿片类药物(舒芬太尼或芬太尼)联合使用的方法。麻醉师认为硬膜外镇痛缓解分娩疼痛的最佳使用频率比助产士更高(分别为19%和11%,p<0.01)。在回答哪些因素限制了硬膜外镇痛的频率时,麻醉师指出了与助产士态度相关的因素,而助产士指出了与麻醉师相关的因素。只有五家医院提供了关于分娩时可采用的各种镇痛方法的书面信息。大多数助产士认为她们产科病房采用的镇痛方法良好或优秀。剖宫产率为12%;55%的病例使用脊髓麻醉,17%使用硬膜外麻醉,28%使用全身麻醉。

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