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.