安春梅 郭燕 陈静 王泳力 邢国鑫 杨芳

【摘 要】目的：探讨椎管拔管时间差异对自然分娩的孕产妇的镇痛影响。方法：选取2020年7月至2021年3月在我院采取椎管镇痛方式进行自然分娩的产妇共100例，分组研究，实验组为自愿在产后2小时拔除椎管的椎管内镇痛分娩的人群；对照组为同时段自愿在产后6小时拔除椎管内导管的人群。然后对比分析两组产妇在术后的疼痛反应及两组产妇对椎管拔管时间的满意程度。结果：两组产妇在产后2小時的疼痛感评分基本相同，数据不存在统计学差异；在产后6h的对照组产妇的镇痛感评分为（79.4±4.3）分，略高于同时期较早拔管的实验组的（71.3±2.4）分，统计学数据差异不明显。较早拔管的实验组的产妇对生产具有更高的满意程度，满意率达到96%，而6h后拔管的对照组产妇可能因插管时间长造成的不适感如胶布粘贴时间长出现皮肤红、瘙痒、水泡，腿软无力，持续低热而满意率较低，仅为86%，两组数据差异明显。结论：产后2h椎管内导管拔除既能为产后镇痛保证效果，更能够提高产妇的产后舒适度。

【关键词】自然分娩；椎管；阻滞麻醉；镇痛效果

Analysis of the analgesic effect of intraspinal block anesthesia in pregnant women with natural delivery

An Chunmei，Guo Yan，Chen Jing， Wang Yongli，Xing Guoxin，Yang Fang（corresponding author） Shuangyashan Maternal and Child Health Hospital， Heilongjiang Shuangyashan 155100， China

【Abstract】Objective：To investigate the effect of the time difference of spinal canal extubation on the analgesia of pregnant women who gave birth naturally.Methods：A total of 100 parturients who were given spontaneous delivery by spinalcanalanalgesia in our hospital from July 2020 to March 2021 were selected for group study. The experimental group was the population who voluntarily removed the spinal canal within2 hours postpartum. The control group was the population who voluntarily removed the intraspinal catheterat 6 hours after delivery at the same time. Then， the postoperative pain response of the two groups of parturients and the satisfaction degree of the two groups of parturients with the time of spinal canal extubation were compared and analyzed. Results： The pain scores of the two groups of parturients at 2 hours postpartum were basically the same， and there was no statistical difference in the data； the control group at 6 hours postpartum had a pain score of（79.4±4.3）points，which was slightly higher than（71.3±2.4）points in the experimental group with early extubation at the same period，and the statistical data was not significantly different.The pregnant women in the experimental group who were extubated earlier had a higher degree of satisfaction with delivery， with a satisfaction rate of 96%，while the women in the control group who were extubated after 6 hours may experience discomfort due to the long intubation time， such as the appearance of skin on the tape for a long time were redness， itching， blisters， weak legs， persistent low fever with lower satisfaction rate， only 86%， there is a significant difference between the two groups of data.Conclusion：Removal of the spinal catheter 2h postpartum can not only ensure the effect of postpartum analgesia， but also improve the postpartum comfort of the parturient..

【Key？Words】Natural delivery； Spinal canal； Block anesthesia； Analgesic effect

随着三胎的逐渐放开，越来越多的人认识到自然分娩对孕妇产后恢复与新生儿健康的重要性，但是自然分娩给产妇带来的疼痛感是十分强烈的，因此在临床医学上，目前产妇主要使用镇痛的方式降低生产的不适感。同时孕产妇对椎管内镇痛分娩产后舒适度的要求越来越高，如何能够提升产后镇痛持续时间成为一个重要的医学问题。……