高平　汤园园　高晓增

[摘要] 目的 探讨麻醉护士主导的镇痛管理对分娩产妇的镇痛效果。 方法 选择2017年9～11月华北理工大学附属医院收治的临产妇100例，按抽签法随机分为麻醉护理组和助产护理组，每组各50例。助产护理组分娩镇痛时给予分娩产房护理常规，麻醉医师按照预先设置实施镇痛，无麻醉护士参与；麻醉护理组在此基础上由麻醉护士进行围生期镇痛管理。比较两组产妇产程疼痛情况、镇痛满意度及麻醉药物不良反应发生率。 结果 麻醉护理组在潜伏期、活跃期、宫口近全时、宫口开全时疼痛评分明显低于助产护理组（P < 0.05）；麻醉护理组镇痛满意度明显高于助产护理组（P < 0.05）；用药不良反应发生率明显低于助产护理组（P < 0.05）。 结论 麻醉护士主导的镇痛管理可降低产妇的分娩时疼痛程度，提高产妇对镇痛管理的满意度，确保了母婴安全，值得临床推广。

[关键词] 麻醉护士；镇痛管理；分娩镇痛

[中图分类号] R473.71 [文献标识码] A [文章编号] 1673-7210（2018）09（b）-0133-04

[Abstract] Objective To explore the effect of anesthesia management led by anesthesia nurses on the analgesic effect of delivery women. Methods From September to November 2017， in the Affiliated Hospital of North China Polytechnic University， 100 parturients were selected and randomly divided into anaesthesia care group and midwifery care group by envelope method， with 50 cases in each group. The midwifery care group was given routine nursing delivery， the analgesia was carried according to predefined by the anesthetist， without anesthesia nurses participating. The anesthesia care group was given analgesia management during the perinatal period of the anesthesia nurses. The pain condition， satisfaction degree of analgesia and incidence of adverse drug reactions in two groups were compared. Results The pain scores of latent period， active period， near full dilatation of the uterine orifice and full dilatation of the uterine orifice in anesthesia care group were significantly lower than those in midwifery care group（P < 0.05）； the analgesia satisfaction in anesthesia care group was significantly higher than that in midwifery care group（P < 0.05）； the rate of adverse drug reaction occurrence in anesthesia care group was lower than that in midwifery care group（P < 0.05）. Conclusion The anesthesia management led by anesthesia nurses can relieve the pain during childbirth， improve the satisfaction of the management of the pain， and ensure the safety of the mother and infants， it is worthy of clinical promotion.

[Key words] Anesthesia nurse； Analgesia management； Labor analgesia

分娩疼痛是由子宮收缩、宫口扩张、先露部对会阴压迫引起的剧烈疼痛，很多产妇由于惧怕这种疼痛而选择剖宫产分娩[1]。分娩镇痛是使用药物及非药物方法有效减轻或消除分娩疼痛，是一项对产妇、胎儿均安全有效的镇痛措施[2]。由于孕妇对分娩镇痛的认知程度、产科医生、助产士的接受程度、麻醉科开展新业务的参与意识以及无痛的自然分娩与剖宫产手术的收益差额等因素的影响，我国的分娩镇痛率与发达国家相比存在着较大差距[3]。麻醉护士掌握分娩镇痛技术的操作、基本原理及常见合并症的抢救措施，能进行详尽的麻醉知识宣教，在分娩镇痛疼痛管理方面有独特的优势[4]。查阅文献既往有分娩镇痛护理配合的研究，但未涉及麻醉护士对静脉自控给药分娩镇痛的产程调试和镇痛管理。……