六、其他非主流分娩镇痛法 Toscano等(26)用2-3%七氟醚混合氧气和空气给产妇在每次宫缩前吸入, 50例产妇VAS评分从8.7降低到3.3。新生儿Apgar评分在出生后1和5 分钟分别为9和10。作者认为本法可有效缓解分娩痛。 有报告用随机双盲对照研究法, 压迫刺激产妇穴位三阴交30分钟可有效缓解疼痛, 并缩短总产程, 可显著降低剖宫产率。 社会心理因素对分娩痛有影响,并可对产妇健康以及产妇和新生儿的关系有暂时或长期影响。本研究对35例产妇进行调查表明,焦虑度(Anxiety Sensitivity Index)可预示(焦虑敏感指数法,分娩疼痛程度(McGill Pain疼痛问卷), 社会和其他心理因素也对分娩程度有一定影响。 有人研究了音乐对分娩痛的影响。分娩活跃期连续听3小时温和音乐能缓解分娩痛的疼痛和紧张忧虑,重度产痛推迟1小时来临。 其他非主流方法如皮内注水、热水浴等都有用于分娩镇痛的报道。 小 结 总之,世界各国由于发展不平衡,对分娩镇痛的认识、采用的方法和分娩镇痛的普及程度都有差别。由于分娩镇痛不仅关系到提高产妇生活质量、维护她们的尊严,也直接影响到母子的平安,因此人们这一领域的探讨一直没有停止。目前椎管内镇痛包括EA和腰硬联合镇痛已经成为分娩镇痛的主流方法,特别是新型局麻药和阿片类药物的应用,使得这重方法更安全和有效。超短效阿片类药物瑞芬太呢的发现,使得有椎管内阻滞有禁忌症的产妇有可能得到良好的镇痛而不影响胎儿的遇后。 参考文献 (1) Borowska A, Szymusik I, Wielgos M, et al. Retrospective assessment of epidural analgesia during labor according to parturients. Ginekol Pol. 2005 Apr;76(4):277-83. (2) Minhas MR, Kamal R, Afshan G, et al. Knowledge, attitude and practice of parturients regarding Epidural Analgesia for labour in a university hospital in Karachi. 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