Evaluation of efficacy of intravenous nalbuphine before epidural labor analgesia in inhibiting uterine contraction pain in primiparae
10.3760/cma.j.cn131073.20220120.00913
- VernacularTitle:硬膜外分娩镇痛前静脉注射纳布啡用于抑制初产妇宫缩疼痛的价值
- Author:
Lei XIE
1
;
Jingfa SHI
;
Rong ZHANG
;
Xiangdong FANG
Author Information
1. 安徽省妇幼保健院麻醉科,合肥 230001
- Keywords:
Nalbuphine;
Spinal puncture;
Labor pain;
Analgesia, obstetrical;
Analgesia, epidural
- From:
Chinese Journal of Anesthesiology
2022;42(9):1086-1088
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the value of nalbuphine intravenously injected before epidural labor analgesia in inhibiting uterine contraction pain in primiparae.Methods:A total of 140 expectant primiparae who were suitable and willing to receive epidural labor analgesia with a singleton fetus in vertex presentation, aged 20-40 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅱ, with their cervical dilation of 2-3 cm, were divided into nalbuphine group (N group) and routine control group (C group), with 70 cases in each group.Group N received intravenous injection of nalbuphine 0.1 mg/kg (in normal saline 5 ml) at 10 min before epidural puncture, while group C received intravenous injection of the equal volume of normal saline at 10 min before epidural puncture.The epidural puncture-related items including the intensity of pain (Numeric Rating Scale [NRS] scores) and degree of sedation-agitation (Riker sedation agitation scores) during uterine contraction, duration of epidural procedure, parturients′ satisfaction with epidural puncture, successful epidural catheterization at first attempt and complications (nerve paraesthesia and inadvertent intravascular punctures) were recorded.Results:Compared with group C, the NRS scores and Riker scores for uterine contraction pain were significantly decreased during epidural procedure ( P<0.05), with NRS score <6 and Riker sedation agitation scores of 4, the duration of epidural puncture was shortened, the success rate of epidural puncture at first attempt was increased(51%/70%), and the incidence of nerve paraesthesia and inadvertent intravascular puncture was decreased(17%/6%, 14%/4%), and the parturients′ satisfaction with epidural puncture was increased in group N ( P<0.05). Conclusions:Nalbuphine 0.1 mg/kg intravenously injected before epidural labor analgesia can safely and effectively reduce uterine contraction pain without limb agitation, which is helpful in implementating epidural puncture in primiparae.