Application effect and clinical study of painless delivery in Tibet / 中国医师杂志

ABSTRACT

Objective:In order to establish a painless delivery detection system in plateau area, promote the concept of painless delivery, reduce the cesarean section rate, the clinical study of painless childbirth in Tibet was carried out.Methods:150 primiparas in Lhasa People's Hospital from January 2018 to Juen 2019 were prospectively collected, which were randomly divided into sufentanil and ropivacaine groups (group A, n=50) and fentanyl and ropivacaine (group B, n=50) and the control group without analgesia (group C, n=50); The general conditions of the patients before and after delivery were collected. The visual analogue scale (VAS) score was used to observe and record the delivery process and results. The Apgar score of newborns was performed, and the umbilical artery blood was taken for blood gas analysis. Results:The first and second stage of labor in group A and B were shorter than those in group C ( P<0.05); there was no difference in the third stage of labor and postpartum bleeding between the three groups ( P>0.05). The VAS scores of groups A and B were lower than that of group C ( P<0.05), while there was no difference between group A and group B ( P>0.05). There was no difference in pH value of umbilical artery blood between the three groups ( P>0.05). The umbilical artery blood PO 2 of group A and group B was higher than those of group C ( P<0.05), while there was no difference between group A and group B ( P>0.05). The umbilical artery blood PCO 2 of group A and group B was lower than that of group C( P<0.05), while there was no difference between group A and group B ( P>0.05). The cesarean section rate in group C was higher than that in groups A and B ( P<0.05). There was no difference in fetal heart rate, fetal distress, and neonatal asphyxia among the three groups ( P>0.05). There was significant difference in the overall incidence of adverse conditions in the three groups ( P<0.05). The Apgar scores of the newborns in groups A and B were higher than those in the C group at 1 min postpartum ( P<0.05), while there were no difference in the Apgar scores among the three groups at 5 and 10 min postpartum ( P>0.05). Conclusions:Painless delivery in plateau area can reduce the pain of delivery and the rate of cesarean section, and has high safety and reduce the adverse effects on mothers and infants, which is worthy of clinical promotion.