两种局部麻醉方法在会阴侧切缝合中镇痛效果比较.pdf

《两种局部麻醉方法在会阴侧切缝合中镇痛效果比较.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、实用临床医学2014年第15卷第1期Practica／ClinicalMedicine，2ol4。Vol15，No1·77·两种局部麻醉方法在会阴侧切缝合中镇痛效果比较李谷，金桂英，杨丽兰(南昌大学第一附属医院妇产科，南昌330006)摘要：目的观察两种会阴局部麻醉方法对会阴侧切缝合的镇痛效果。方法选取40O例经阴道分娩的初产妇，按随机数字表法分为观察组200例和对照组200例。观察组采用新改良局部麻醉方法：侧切前采用9号针头在侧切口范围内紧贴皮肤下缘注射2％盐酸利多卡因3mL，再由外向内注入2％盐酸利多卡因5mL局部浸润麻醉，缝合前加用2％盐酸利多卡因

2、2mL淋于阴道内伤口用于加强麻醉效果。对照组采用传统阴部神经阻滞局部麻醉法。结果观察组在会阴伤口缝合时及术后2h内的伤I=I镇痛效果明显优于对照组(P--0．000)；观察组会阴侧切口I期愈合率(96．0％)高于对照组(87．5％)(P=-O．02)；观察组产后尿潴留发生率低于对照组(0．OO1)；2组新生儿出生1min及5minAp．gar评分差异无统计学意义(P>0．05)。结论新改良局部麻醉易于操作，镇痛效果明显优于传统方法，可减少产后尿潴留。极大减轻产妇痛苦，且不会增加对产妇及新生儿的危害。关键词：局部麻醉；会阴侧切；缝合；镇痛中图分类号：R71

3、4．3文献标志码：A文章编号：1009—8194(2014)01—0077-03ComparisonofTwoMethodsofTopicalAnesthesiaforEpisiotomySsuturningRLIGu，J豆NGui-ying，rANGLi-lan(DepartmentofObstetricsandGynecology，theFirstAffiliatedHospitalofNartchangUniversity,Nanchang330006，China)ABSTRACT：ObjectiveTocomparetheefficaciesof

4、twomethodsoflocalanesthesiaforepisiotomysuturing．MethodsFourhundredprimiparaswhounderwentvaginaldeliverywererandomlydividedintotwogroups，with200primiparasineachgroup．Inobservationgroup，3mLof2％lidocainehydrochloridewasadministeredintotheincisionareathroughtheskinedgewitha9一gaugene

5、edle．Then．5mLof2％lidocainehydrochloridewasinjectedfromoutsidetoinsideforlocalinfiltrationanesthesia．Moreover．2mLof2％lidocainehydrochloridewasusedinvaginalwoundtos~engthentheanestheticeffect．Incontrolgroup，topicalanesthesiawasinducedbyblockingthepudendalnerve．ResultsComparedwithtr

6、aditionalpudendalnerveblock，themodifiedlocalanesthesiaimprovetheanalgesiceffectatthetimeofsuturingpefineumwoundandwitllin2hoursafteroperation(P=O．000)，increasedthestage1woundhealingrate(96．0％VS87．5％，=0．02)，andreducedtheincidenceofpostpartumurinaryretention(P=0．001)．N0significantd

7、iferencesinApgarscoresatoneandfiveminutesinnewbornswerefoundbetweenthetwogroups(尸>o．05)．ConclusionThemodifiedtechniqueforlocalanesthesiaiSeasytooperateandhasbetteranalgesicefectthantraditionalmethod．Furthermore，themodifiedtechniquereducespostpartumurinaryretentionandrelievesmater

8、nalpainwithoutincreasedharmtomothersandn