穴位注射减少腰硬联合麻醉结合自控硬膜外麻醉实施分娩镇痛的药物剂量

Min-li; 敏丽 HUANG; 黄; Chang-ping; 畅平 FANG; 方; Hai-yan; 海燕 ZHAO; 赵; Zi-jing; 子敬 ZHANG; 张; Shu-zhen; 淑贞 WU; 邬; Wei; 玮 YI; 易; Shang-rong; 尚荣 LI; 黎; Ling-ling; 玲玲 WU; 吴

doi:10.1007/s11655-021-3501-8

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穴位注射减少腰硬联合麻醉结合自控硬膜外麻醉实施分娩镇痛的药物剂量

Acupuncture Research | Updated：2022-03-18

- 穴位注射减少腰硬联合麻醉结合自控硬膜外麻醉实施分娩镇痛的药物剂量
- Acupoint Injection Decreases Anesthetic Cosumption during Combined Spinal-Epidural and Patient-Controlled Epidural Labor Analgesia
- Chinese Journal of Integrative Medicine 2022年28卷第3期页码：257-262
- Affiliations：
  
  1.Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou (510630), China
  2.Medical College of Acupuncture-Moxibustion and Rehabilitation,Guangzhou University of Chinese Medicine, Guangzhou (510006),China
  3.Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou (510630), China
- Author bio：
  
  Prof. WU Ling-ling, E-mail: wulingling2003@163.com
- Funds：
  
  the Guangdong Science and Technology Department of China(2016A020226051)
- DOI：10.1007/s11655-021-3501-8
  中图分类号：
- 纸质出版日期：2022-03-01，
  
  网络出版日期：2021-11-03，
  
  录用日期：2021-03-05
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Min-li, 敏丽 HUANG, 黄, 等. 穴位注射减少腰硬联合麻醉结合自控硬膜外麻醉实施分娩镇痛的药物剂量[J]. Chinese Journal of Integrative Medicine, 2022,28(3):257-262.

Min-li, 敏丽 HUANG, 黄, et al. Acupoint Injection Decreases Anesthetic Cosumption during Combined Spinal-Epidural and Patient-Controlled Epidural Labor Analgesia[J]. Chinese Journal of Integrative Medicine, 2022,28(3):257-262.
Min-li, 敏丽 HUANG, 黄, 等. 穴位注射减少腰硬联合麻醉结合自控硬膜外麻醉实施分娩镇痛的药物剂量[J]. Chinese Journal of Integrative Medicine, 2022,28(3):257-262. DOI： 10.1007/s11655-021-3501-8.

Min-li, 敏丽 HUANG, 黄, et al. Acupoint Injection Decreases Anesthetic Cosumption during Combined Spinal-Epidural and Patient-Controlled Epidural Labor Analgesia[J]. Chinese Journal of Integrative Medicine, 2022,28(3):257-262. DOI： 10.1007/s11655-021-3501-8.

摘要

目的:

探讨穴位注射能否改善采用腰硬联合麻醉 (combined spinal-epidural analgesia

CSEA) 及自控硬膜外麻醉 (patient-controlled epidural analgesia

PCEA) 实施分娩镇痛产妇的镇痛效果及分娩结局.

方法:

前瞻性收集2017 年7月至2019年12月期间病例共307例

按照随机数字表法将产妇随机分为穴位注射联合CSEA+ PCEA组 (AICP组

n=168) 和CSEA+ PCEA组 (CP组

n=139) . 两组产妇均在宫口扩张3 cm实施CSEA+ PCEA

AICP组病人同时选取双侧足三里 (ST 36) 和三阴交 (SP 6) 实施穴位注射. 主要结果是视觉模拟量表 (Visual Analogue Scale

VAS) 评分

次要结果是分娩结局及麻醉药物剂量. 所有产妇实施干预后均进行安全性评价.

结果:

AICP组产妇在实施分娩镇痛10、30、60、120分钟时的VAS评分均低于CP组 (

均

0.05) ; AICP组产妇潜伏期较CP组缩短 (

0.05) ; AICP组产妇的麻醉药物剂量及宫缩乏力、发热、瘙痒、尿潴留的发生率均低于CP组 (

均

0.05) .

结论:

穴位注射联合CSEA+ PCEA实施分娩镇痛可减少麻醉药物剂量

改善镇痛效果并降低副作用的发生率. (注册号: ChiMCTR-2000003120)

Abstract

Objective:

To explore if acupoint injection can improve analgesic effects or delivery outcomes in parturients who received combined spinal-epidural analgesia (CSEA) and patient-controlled epidural analgesia (PCEA) for labor analgesia.

Methods:

A total of 307 participants were prospectively collected from July 2017 to December 2019. The participants were randomized into the combined acupoint injection with CSEA plus PCEA group (AICP group

=168) and CSEA plus PCEA group (CP group

=139) for labor analgesia using a random number table. Both groups received CSEA plus PCEA at cervical dilation 3 cm during labor process

and parturients of the AICP group were implemented acupoint injection for which bilateral acupoint of Zusanli (ST 36) and Sanyinjiao (SP 6) were selected in addition. The primary outcome was Visual Analogue Scale (VAS) score

and the secondary outcomes were obstetric outcomes and requirement of anesthetics doses. Safety evaluations were performed after intervention.

Results:

The VAS scores were significantly lower in the AICP group than in the CP group at 10

and 120 min after labor analgesia (all

0.05). The latent phase of the AICP group was shorter than that of the CP group (

0.05). There were less additional anesthetics consumption

lower incidences of uterine atony

fever

pruritus and urinary retention in the AICP group than those in the CP group (all

0.05).

Conclusion:

Acupoint injection combined CSEA plus PCEA for labor analgesia can decrease the anesthetic consumption

improve analgesic quality

and reduce adverse reactions in the parturients. (Registration No. ChiMCTR-2000003120)

关键词

穴位注射腰硬联合麻醉分娩镇痛麻醉药物剂量多模式

Keywords

acupoint injectioncombined spinal-epidural analgesialabor analgesiaanesthetic consumptionmultimodal analgesia

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