分析无痛分娩中的物质水平和疼痛感觉:脊髓硬膜外镇痛的影响。

IF 2.8 3区 医学 Q2 NEUROSCIENCES
Fahmi Agnesha, Eti Nurwening Solikhah, Djayanti Sari, Rianza Ainunnisa
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引用次数: 0

摘要

背景:炎症会影响子宫收缩和扩张,从而影响分娩。疼痛通常与组织缺血有关,涉及一氧化氮(NO)、TNF-α 和 P 物质(SP)等介质。神经轴镇痛,包括使用左布比卡因的脊柱硬膜外联合镇痛(SEA),因其在无痛分娩中的有效性和最小副作用而受到青睐。了解无痛分娩技术对 NO、TNF-α 和 P 物质水平等生物分子过程的影响对于改善疼痛管理策略至关重要。本研究调查了使用左旋布比卡因进行无痛分娩的产妇所受的这些影响,有助于开发新型镇痛药物和加强产科护理:本实验研究在印度尼西亚的一家综合医院进行,共有 60 名即将在 Permata Hati Metro 医院经阴道分娩的产妇参与。研究使用血清进行分析,并使用 ELISA 试剂盒评估血清中 NO、TNF-α 和 SP 的水平:结果:与对照组相比,SEA 组在治疗前和治疗后的 NO 水平明显下降(P < 0.05)。然而,治疗前后各组间 TNF-α 水平无明显差异(P > 0.05)。此外,治疗前各组间的 SP 水平无明显差异,但治疗后有明显差异(P < 0.05)。与对照组相比,SEA能明显减轻分娩疼痛(P < 0.05),明显改善生命体征和APGAR评分,同时还能缩短产程(P < 0.001):总之,在无痛分娩过程中使用左旋布比卡因进行SEA可明显降低NO水平,并有降低TNF-α和P物质水平的趋势,尽管没有统计学意义,但对患者和婴儿都有临床益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analyzing Substance Levels and Pain Perception in Painless Labor: The Impact of Spinal Epidural Analgesia.

Background: Inflammation affects labor by influencing contractions and dilation. Pain, often linked to tissue ischemia, involves mediators like nitric oxide (NO), TNF-α, and substance P (SP). Neuraxial analgesia, including combined spinal epidural analgesia (SEA) with levobupivacaine, is preferred for its effectiveness and minimal side effects in painless labor. Understanding the impact of painless labor techniques on biomolecular processes such as NO, TNF-α, and substance P levels is crucial for improving pain management strategies. This study investigates these effects in parturients undergoing SEA with levobupivacaine, contributing to the development of novel pain medications and enhancing obstetric care.

Methods: This experimental study, conducted at a General Hospital in Indonesia, involved 60 expectant mothers in labor or in the third trimester, expected to give birth vaginally at Permata Hati Metro Hospital. Blood serum was used for analysis, and serum NO, TNF-α, and SP levels were assessed using ELISA kit.

Results: There's a significant decrease in NO levels before and post-treatment in the SEA group compared to the control group (p < 0.05). However, no significant difference in TNF-α levels was observed between groups before and after treatment (p > 0.05). Additionally, there was no significant difference in SP levels between groups before treatment, but a significant difference was seen after treatment (p < 0.05). SEA significantly reduced labor pain compared to the control group (P < 0.05), with notable improvements in vital signs and APGAR scores, while also shortening labor duration (P < 0.001).

Conclusion: In conclusion, SEA with levobupivacaine during painless labor reduces NO levels significantly and shows a trend of decreasing TNF-α and substance P levels, although not statistically significant, with clinical benefits for both patients and babies.

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来源期刊
Molecular Pain
Molecular Pain 医学-神经科学
CiteScore
5.60
自引率
3.00%
发文量
56
审稿时长
6-12 weeks
期刊介绍: Molecular Pain is a peer-reviewed, open access journal that considers manuscripts in pain research at the cellular, subcellular and molecular levels. Molecular Pain provides a forum for molecular pain scientists to communicate their research findings in a targeted manner to others in this important and growing field.
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