阴部神经阻滞麻醉在会阴侧切缝合中临床应用.docVIP

阴部神经阻滞麻醉在会阴侧切缝合中临床应用 　　摘要：目的 比较阴部神经阻滞麻醉联合局部浸润麻醉在会阴侧切缝合中的镇痛效果。方法 将需要行会阴侧切术的初产妇62例随机分成观察组和对照组各31例。观察组用2%利多卡因20ml~40ml在会阴侧切处行阴部神经阻滞麻醉联合局部浸润麻醉下行会阴缝合术；对照组只用2%的利多卡因在会阴侧切处行会阴局部麻醉下行会阴缝合术。结果 观察组的镇痛效果的总有效率和显效率分别为96.77%和77.42%，均高于对照组的54.84%和32.26%，无效率3.22%低于对照组45.16%，以上差异均有统计学意义(P0.05）。结论 阴部神经阻滞麻醉联合局部浸润麻醉在会阴侧切缝合中镇痛起效快，缝合时间短，出血少，操作简单，安全，无不良反应，值得在临床上推广。 　　关键词：阴道分娩,阴部神经阻滞麻醉,局部浸润麻醉,会阴侧切,镇痛 　　Pudendum Nerve Blocking Anesthesia Sclinical Application in Episiotomy Suture 　　YU Chun-yan 　　(Shizong Town Health Center in Tongzhou District,Nantong226300,Jiangsu,China) 　　Abstract：ObjectiveTo compare pudendum nerve blocking anesthesia combined local infiltration anesthesia's analgesic effects on episiotomy suture.Methods62 cases of puerperas who need lateral episiotomy were randomly divided into observation group and control group(31 cases for each).The observation group used 2%lidocaine(20~40ml)to have pudendum nerve blocking anesthesia combined local infiltration anesthesia at the episiotomy place and perineorrhaphy.The control group only used 2%lidocaine at the episiotomy place to have the perineum local anesthesia and perineorrhaphy.ResultsThe analgesia effect of total effective rate and efficiency in the observation group were 96.77%and 77.42%,the effective rates were both higher than the control group's(54.84%and 32.26%).The inefficiency(3.22%)in observation was lower than the control group's(45.16%),the above differences were statistically significant(P0.05）.ConclusionThe pudendum nerve blocking anesthesia combined local infiltration anesthesia's analgesic effects were fast,The suture time is short,less bleeding,safe,effective and simply operated.It has no adverse reaction and is worth to be popularized. 　　Key words：Vaginal delivery;Pudendum nerve block anesthesia;Localinfiltrationanesthesia;Lateral episiotomy;Analgesia 　　随着时间的推移，社会的发??，产前健康教育的开展，越来越多的产妇及家属已经意识到剖宫产的弊病和自然分娩的好处[1]。但由于初产妇会阴过紧,会阴过短，耻骨弓过低，胎儿过大等原因常给阴道分娩带来了一定的困难[2]。适时果断地进行会阴切开术对母婴均有利，因为会阴侧切既可减轻产妇分娩时骨盆底肌肉的阻力，也可缩短第二产