Abstract：
This work compared the effects of dural puncture epidural (DPE), combined spinal epidural analgesia (CSEA) and epidural analgesia (EA) on labor analgesia for primiparae and their impacts on maternal and infant safety. A total of 204 primiparae in need of labor analgesia for vaginal delivery were allocated to DPE, CSEA and EA groups. At 10 min, 30 min and 1 h after analgesia, the DPE and CSEA groups showed lower VAS scores and quicker onset of action than EA group. There was no significant difference in the duration of analgesia and labor and fetal decelerations among the 3 groups. At 1 min and 5 min after childbirth, the neonatal Apgar scores showed no significant difference between the 3 groups. The Bromage scores of DPE and EA groups were lower than those of CSEA group. The incidence of pruritus, hypotension, and postpartum headache in DPE and EA groups were lower than those in CSEA group. To sum up, the efficacy of DPE in labor analgesia for primiparae is similar to that of CSEA, with no obvious effect on labor stage and neonatal Apgar score, no additional complications and less LLMB, pruritus, hypotension and postpartum headache.
摘要：
这项工作比较了硬脑膜穿刺硬膜外（DPE）的效果，腰硬联合镇痛（CSEA）和硬膜外镇痛（EA）对初产妇分娩镇痛的影响及其对母婴安全的影响。共204例需要分娩镇痛阴道分娩的初产妇被分配到DPE,CSEA和EA组。在10分钟，镇痛后30分钟和1小时，与EA组相比,DPE组和CSEA组的VAS评分较低,起效较快.3组的镇痛时间、产程和胎儿减速时间无显著差异。在分娩后1分钟和5分钟，新生儿Apgar评分3组间差异无统计学意义。DPE和EA组的Bromage评分低于CSEA组。瘙痒的发生率，低血压,DPE和EA组产后头痛低于CSEA组。总而言之,DPE在初产妇分娩镇痛中的疗效与CSEA相似，对产程和新生儿Apgar评分无明显影响,没有额外的并发症和更少的LLMB，瘙痒,低血压和产后头痛。
