Effects of different epidural anesthesia regimens on pain and postpartum pelvic floor function of primiparas
10.7683/xxyxyxb.2023.12.009
- VernacularTitle:不同硬膜外麻醉方案对初产妇疼痛和产后盆底功能的影响
- Author:
Yajun CAO
1
;
Wenchun WU
;
Min DONG
;
Xia YAN
Author Information
1. 湖北中医药大学附属襄阳医院麻醉科,湖北 襄阳 441000
- Keywords:
epidural anesthesia;
primipara;
pain;
pelvic floor function
- From:
Journal of Xinxiang Medical College
2023;40(12):1146-1150
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effects of different epidural anesthesia regimens on pain degree and postpartum pelvic floor function of primiparas.Methods A total of 80 primiparas who underwent painless epidural anesthesia delivery in Xiangyang Hospital Affiliated to Hubei University of Traditional Chinese Medicine from September 2021 to September 2022 were selected as the research subjects.The primiparas were divided into control group(n=40)and observation group(n=40)according to the anesthesia plan.The primiparas in the control group received epidural anesthesia with ropivacaine combined with physiological saline,while the primiparas in the observation group received epidural anesthesia with ropivacaine combined with sufentanil.The rate of natural delivery,rate of cesarean section,rate of vaginal delivery and the duration of each labor of primiparas were compared between the two groups;the analgesic effect of primiparas in the two groups was evaluated by pain visual analogue scale(VAS)at 5,60 min after analgesia,full opening of the cervix and postpartum 24 hours;the asphyxia sta-tus of newborns in the two groups was evaluated by neonatal Apgar score at 1,5 min after birth;the complications of nausea and vomiting,cervical or perineal injuries,urinary retention of puerperas and neonatal asphyxia were recorded and the total inci-dence of complications was compared between the two groups.At 6-8 weeks after delivery,pelvic floor functional indicators such as fiber muscle strength,pelvic floor muscle closure contraction force,and static tension of pelvic floor muscles of postpar-tum women in the two groups were measured by biological stimulus feedback instrument.Results The natural delivery rate,vaginal delivery rate and cesarean section rate of primiparas in the control group was 72.5％(29/40),7.5％(3/40),20.0％(8/40),respectively;the natural delivery rate,vaginal delivery rate and cesarean section rate of primiparas in the observation group was 90.0％(36/40),5.0％(2/40)and 5.0％(2/40),respectively.The natural delivery rate of primiparas in the ob-servation group was significantly higher than that in the control group,and the cesarean section rate was significantly lower than that in the control group(P＜0.05);there was no significant difference in the vaginal delivery rate of primiparas between the two groups(P＞0.05).The first and second stages of labor of primiparas in the observation group were significantly shorter than those in the control group(P＜0.05),and there was no significant difference in the third stage of labor of primiparas be-tween the two groups(P＞0.05).The VAS score of primiparas in the observation group was significantly lower than that in the control group at 5,60 min after analgesia,full opening of the cervix and postpartum 24 hours(P＜0.05).There was no signifi-cant difference in the Apgar score of newborns between the two groups at 1,5 min after birth(P＞0.05).The total incidence of complications in the control group and the observation group was 42.50％(17/40)and 20.00％(8/40),respectively;the total incidence of complications in the observation group was significantly lower than that in the control group(x2=4.713,P＜0.05).The fiber muscle strength and pelvic floor muscle closure contraction force of postpartum women in the observation group were significantly higher than those in the control group,the static tension of pelvic floor muscles was significantly lower than that in the control group(P＜0.05).Conclusion Sufentanil combined with ropivacaine epidural anesthesia can improve the analgesic effect of primiparas during childbirth,reduce the cesarean section rate,shorten the labor process,and facilitate the recovery of pelvic floor function in primiparas,reduce maternal and infant complications.
