■探讨分娩镇痛期间硬脑膜穿刺硬膜外(DPE)阻滞技术对胎儿心率变异性(HRV)的影响。
选择2021年4月至2021年10月在我院就诊的足月初产妇60例,随机分为硬膜外镇痛(CEA)组和硬膜穿刺硬膜外镇痛(DPEA)组(30例)。硬膜外穿刺成功后,CEA组行常规硬膜外导管(EC),DPE组采用脊髓麻醉针(作为EC)穿刺硬脑膜至蛛网膜下腔。通过EC注射麻醉药。温度感觉平面达到T10(W1)和视觉模拟疼痛评分(VAS)的时间,基线心率评分,振幅变化分数,周期变化分数,加速度分数,减速分数,记录W1后第一次收缩的总分。1分钟时的阿普加得分,5分钟,记录分娩后10分钟的新生儿。
■CEA组麻醉起效时间明显长于DPEA组(p<.05)。然而,W1、VAS、基线心率评分,振幅变化分数,周期变化分数,加速度分数,减速分数,两组之间的W1后第一次收缩总分(p>.05)。此外,1分钟时的阿普加得分,两组新生儿分娩后5分钟和10分钟差异无统计学意义(p>0.05)。
■与CEA相比,分娩镇痛中的DPE阻滞技术减轻了产妇的疼痛,对胎儿HRV和新生儿无不良影响。
UNASSIGNED: To explore the effect of dural puncture epidural (DPE) block technique on fetal heart rate variability (HRV) during labor analgesia.
UNASSIGNED: Sixty full-term primiparas who were in our hospital from April 2021 to October 2021 were selected and randomized into epidural analgesia (CEA) and dural puncture epidural analgesia (DPEA) groups (n = 30). After a successful epidural puncture, routine epidural catheter (EC) was performed in CEA group, and spinal anesthesia needle (as an EC) was used to puncture the dura mater to subarachnoid space in DPE group. Anesthetics were injected through EC. The time when the temperature sensation plane reached T10 (W1) and visual analog pain score (VAS), baseline heart rate score, amplitude variation score, cycle variation score, acceleration score, deceleration score, and total score of the first contraction after W1 were recorded. Apgar scores at 1 min, 5 min, and 10 min of neonates after delivery were recorded.
UNASSIGNED: The onset time of anesthesia in CEA group was significantly longer than that in DPEA group (p < .05). However, there are no significant differences in W1, VAS, baseline heart rate score, amplitude variation score, cycle variation score, acceleration score, deceleration score, and total score of the first contraction after W1 between the two groups (p > .05). Moreover, the Apgar scores at 1 min, 5 min and 10 min of neonates after delivery were not notably different between the two groups (p > .05).
UNASSIGNED: Compared with CEA, DPE block technique in labor analgesia relieves maternal pain without adverse effects on fetal HRV and newborns.