背景:炎症通过影响收缩和扩张影响分娩。疼痛,通常与组织缺血有关,涉及一氧化氮(NO)等介质,TNF-α,P物质(SP)。轴心镇痛,包括联合脊髓硬膜外镇痛(SEA)与左布比卡因,因其在无痛分娩中的有效性和最小的副作用而首选。了解无痛分娩技术对NO等生物分子过程的影响,TNF-α,P物质水平对改善疼痛管理策略至关重要。这项研究调查了左旋布比卡因在接受SEA的产妇中的这些影响,促进新型止痛药的开发和加强产科护理。
方法:本实验研究,在印度尼西亚的一家综合医院进行,涉及60名分娩或妊娠晚期的孕妇,预计在PermataHati地铁医院阴道分娩。用血清进行分析,血清NO,TNF-α,使用ELISA试剂盒评估SP水平。
结果:与对照组相比,SEA组治疗前后NO水平显着降低(p<0.05)。然而,两组治疗前后TNF-α水平差异无统计学意义(p>0.05)。此外,两组治疗前SP水平无显著差异,但治疗后观察到显著差异(p<0.05)。与对照组相比,SEA明显减轻了分娩疼痛(P<0.05)。随着生命体征和APGAR评分的显著改善,同时也缩短了产程(P<0.001)。
结论:结论:无痛分娩期间使用左布比卡因的SEA可显著降低NO水平,并显示出降低TNF-α和P物质水平的趋势,虽然没有统计学意义,对患者和婴儿都有临床益处。
BACKGROUND: Inflammation affects labor by influencing contractions and dilation. Pain, often linked to tissue ischemia, involves mediators like nitric oxide (NO), TNF-α, and substance P (SP). Neuraxial analgesia, including combined spinal epidural analgesia (SEA) with levobupivacaine, is preferred for its effectiveness and minimal side effects in painless labor. Understanding the impact of painless labor techniques on biomolecular processes such as NO, TNF-α, and substance P levels is crucial for improving pain management strategies. This study investigates these effects in parturients undergoing SEA with levobupivacaine, contributing to the development of novel pain medications and enhancing obstetric care.
METHODS: This experimental study, conducted at a General Hospital in Indonesia, involved 60 expectant mothers in labor or in the third trimester, expected to give birth vaginally at Permata Hati Metro Hospital. Blood serum was used for analysis, and serum NO, TNF-α, and SP levels were assessed using ELISA kit.
RESULTS: There\'s a significant decrease in NO levels before and post-treatment in the SEA group compared to the control group (p < 0.05). However, no significant difference in TNF-α levels was observed between groups before and after treatment (p > 0.05). Additionally, there was no significant difference in SP levels between groups before treatment, but a significant difference was seen after treatment (p < 0.05). SEA significantly reduced labor pain compared to the control group (P < 0.05), with notable improvements in vital signs and APGAR scores, while also shortening labor duration (P < 0.001).
CONCLUSIONS: In conclusion, SEA with levobupivacaine during painless labor reduces NO levels significantly and shows a trend of decreasing TNF-α and substance P levels, although not statistically significant, with clinical benefits for both patients and babies.