Effect of dural puncture epidural block technique on fetal heart rate variability during labor analgesia.

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Maternal-Fetal & Neonatal Medicine Pub Date : 2024-12-01 Epub Date: 2024-06-27 DOI:10.1080/14767058.2024.2370398

Bo Zhang, Mengting Xu, Chao Pan, Nan Chen, Liping Shi, Yongxin Zhou, Tao Liu

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引用次数: 0

Abstract

Purpose: To explore the effect of dural puncture epidural (DPE) block technique on fetal heart rate variability (HRV) during labor analgesia.

Methods: Sixty full-term primiparas who were in our hospital from April 2021 to October 2021 were selected and randomized into epidural analgesia (CEA) and dural puncture epidural analgesia (DPEA) groups (n = 30). After a successful epidural puncture, routine epidural catheter (EC) was performed in CEA group, and spinal anesthesia needle (as an EC) was used to puncture the dura mater to subarachnoid space in DPE group. Anesthetics were injected through EC. The time when the temperature sensation plane reached T10 (W1) and visual analog pain score (VAS), baseline heart rate score, amplitude variation score, cycle variation score, acceleration score, deceleration score, and total score of the first contraction after W1 were recorded. Apgar scores at 1 min, 5 min, and 10 min of neonates after delivery were recorded.

Results: The onset time of anesthesia in CEA group was significantly longer than that in DPEA group (p < .05). However, there are no significant differences in W1, VAS, baseline heart rate score, amplitude variation score, cycle variation score, acceleration score, deceleration score, and total score of the first contraction after W1 between the two groups (p > .05). Moreover, the Apgar scores at 1 min, 5 min and 10 min of neonates after delivery were not notably different between the two groups (p > .05).

Conclusion: Compared with CEA, DPE block technique in labor analgesia relieves maternal pain without adverse effects on fetal HRV and newborns.

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硬膜外穿刺阻滞技术对分娩镇痛期间胎儿心率变异性的影响。

目的：探讨硬膜外穿刺阻滞技术对分娩镇痛时胎儿心率变异性（HRV）的影响：选取 2021 年 4 月至 2021 年 10 月在我院分娩的 60 名足月初产妇，随机分为硬膜外镇痛组（CEA）和硬膜外穿刺镇痛组（DPEA）（n = 30）。硬膜外穿刺成功后，CEA 组进行常规硬膜外导管穿刺（EC），DPE 组使用脊髓麻醉针（作为 EC）穿刺硬脑膜至蛛网膜下腔。通过 EC 注射麻醉剂。记录温觉平面达到T10（W1）的时间、视觉模拟疼痛评分（VAS）、基线心率评分、振幅变化评分、周期变化评分、加速评分、减速评分以及W1后第一次宫缩的总分。记录新生儿娩出后 1 分钟、5 分钟和 10 分钟的 Apgar 评分：结果：CEA 组的麻醉开始时间明显长于 DPEA 组（P P > .05）。此外，两组新生儿在产后 1 分钟、5 分钟和 10 分钟的 Apgar 评分没有明显差异（P > .05）：结论：与 CEA 相比，DPE 阻滞技术在分娩镇痛中可减轻产妇疼痛，且不会对胎儿心率变异和新生儿产生不良影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Maternal-Fetal & Neonatal Medicine 医学-妇产科学

CiteScore

4.40

自引率

0.00%

发文量

217

审稿时长

2-3 weeks

期刊介绍： The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.