文档介绍：分娩镇痛进展
天津医科大学总医院
王国林
2006-4 合肥
• 1847年苏格兰产科医生Simpson J给分娩产
妇吸入乙醚以缓解疼痛,得出的印象是药
物可以缓解分娩痛,但同时要关注其副作
用,包括对子宫收缩、腹部肌张力以及对
胎儿的影响
• Epidural analgesia in labour is used by
about 100 000 women in Britain each year
BMJ 2002;325:357
分娩痛产生的机制
理想的分娩镇痛
• dramatically reduce the pain of labour,
while allowing the parturient to actively
participate in the birthing experience.
• In addition, it should have minimal effect
on the fetus or the progress of labour
Regional analgesia for labour
• spinal opiates bined spinal-
epidural (CSE) analgesia
• patient controlled epidural analgesia
• continuous spinal analgesia
• neuraxial blockade (epidural, spinal, CSE,
continuous spinal) provides the most
effective and least depressant analgesia
• Epidural analgesia via a catheter
technique provides excellent pain relief
and the ability to extend the duration of the
block to match the duration of labour, but it
is not "instant" in onset and may be
associated with motor block.