摘要
目的观察针刺麻醉辅助腰硬联合阻滞用于无痛分娩的安全性和可行性。方法将入组98例孕产妇分为2组,观察组采用针刺麻醉,取合谷穴、三阴交穴针刺得气后接韩式穴位电针仪,当宫口开2~3 cm左右时,于L3~4间隙行腰硬联合麻醉;对照组采用腰硬联合麻醉,操作方法同观察组。观察针刺麻醉前(T1)、腰麻前(T2)、腰麻后(T3)、宫口开全(T4)、第二产程过后(T5)各时点VAS评分,第一产程、第二产和第三产程时间和硬膜外麻醉用药量,新生儿产后1 min、5 min Apagar评分及胎儿脐静脉血气分析等指标。结果观察组T2时点VAS评分明显较低,第一产程时间缩短、硬膜外药物用量减少、产后1 min Apagar评分,胎儿脐静脉血气分析(pH值、PaCO2、PaO2、BE)等指标与对照组比较差异有统计学意义(P<0.05)。结论采用多模式联合麻醉方法用于无痛分娩取得了满意效果,临床值得推广。
Objective To investigate the feasibility and safety of acupuncture anesthesia combined with lumbar-epidural combination blocking for painless delivery.Methods A total of 98 puerpera were divided into two groups. The puerpera in observation group were treated by acupuncture anesthesia,with acupuncture at Hegu and Sanyinjiao points, followed by linking Korean-style acupoint electro-acupuncture apparatus. When the mouth of the uterus was opened about 2~3 cm, lumbar-epidural combination anesthesia was performed in the interval of L3-4. However the puerpera in control group were treated by lumbar-epidural combination anesthesia, and the operation method was the same as that in observation group.The VAS scores at T1,T2,T3,T4,T5,and Apagar scores at 1 min,3 min after childbirth as well as blood gas analysis indexes of fetal umbilical vein were analyzed.Results The VAS scores at T2 in observation were significantly lower, the time of the first stage of labor was shortened, the dosage of epidural drugs was decreased, and the Apagar scores at 1 min after childbirth were higher, moreover, there were significant differences in the blood gas analysis indexes of fetal umbilical vein including pH,PaCO2,PaO2,BE and the other indexes between the two groups(P<0.05).Conclusion The multi-mode combination anesthesia for painless delivery can obtain satisfactory effects,therefor, which is worthy of clinical promotion.
作者
杨德志
刘志芳
YANG Dezhi;LIU Zhifang(Department of Anesthesiology,The First Affiliated Hospital of Xingtai Medical College,Hebei,Xingtai 054000,China)
出处
《河北医药》
CAS
2019年第11期1675-1677,1681,共4页
Hebei Medical Journal
关键词
针刺麻醉
腰硬联合阻滞
无痛分娩
acupuncture anesthesia
lumbar-epidural combination blocking
painless labor
