产前硬膜外镇痛与肌肉注射曲马多对分娩结局的比较研究

Syed Basit, Nowsheen Khan, Annum Bano
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摘要

背景:硬膜外镇痛可在不影响神经系统的情况下产生分娩镇痛效果,使产妇在整个分娩过程中保持良好的方向感、完全清醒和警觉。本研究旨在研究硬膜外镇痛和肌肉注射曲马多在不同产程中的效果,并比较硬膜外镇痛和肌肉注射曲马多对产程进展及其结果的影响:方法:使用多参数监护仪对产妇的血流动力学参数进行连续监测。胎儿监测则使用连续心动图(CTG)监测仪进行。自然分娩的初产妇被随机分为两组。第一组接受硬膜外镇痛,第二组接受 IM 曲马多:结果:第一组第一产程持续时间为(167.0±47.2)分钟,第二组第一产程持续时间为(214.4±50.2)分钟。I 组第 III 产程的平均持续时间为 7.9 分钟,II 组为 7.5 分钟。在本研究中,I 组的总产程比 II 组缩短了 47 分钟:结论:分娩时硬膜外镇痛是一种简单有效的无痛安全分娩方法。硬膜外镇痛的效果明显优于肌肉注射曲马多。硬膜外镇痛对产程进展有良好的影响。在发展中国家,设施的可用性是主要的限制因素,而肌肉注射曲马多是一种安全、令人满意的缓解分娩疼痛的药物,因此可作为一种合适的替代方法。
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A comparative study of intrapartum epidural analgesia with intramuscular tramadol on labor outcome
Background: Epidural analgesia produces analgesia in labour without affecting nervous system, allows the mother to be well oriented, fully conscious and alert throughout labour. The aim of this study is to study the effect of epidural analgesia and intramuscular (IM) tramadol in different stages of labour and compare the effect of epidural analgesia with intramuscular tramadol on progress of labour and its outcome. Methods: Continuous monitoring of the haemodynamic parameters of the mother was done using multiparameter monitors. Foetal monitoring was done using continuous cardiotocography (CTG) monitor. Primigravida in spontaneous labour were randomly divided into two groups. Group I received epidural analgesia and group II received IM tramadol. Results: Duration of Ist stage of labour in group I was 167.0±47.2 min and in group II was 214.4±50.2 min. Mean duration of III stage of labour in the present group I was 7.9 min and 7.5 min in the group II. In the present study, total duration of labour is shortened by 47 min in group I compared to group II. Conclusions: Epidural analgesia during labour is a simple and effective method for painless and safe delivery. Analgesia produced by epidural route is significantly more effective than intramuscular tramadol. Epidural analgesia has favourable effect on the progress of labour. In developing nations where availability of facilities is the main limiting factor, intramuscular tramadol which is a safe and satisfactory drug for relief of labour pain, can be considered as a suitable alternative.
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