Effect of pulsed epidural analgesia on nursing care of patients with uterine contraction pain after cesarean section / 中国实用护理杂志

ABSTRACT

Objective:To observe the analgesic effect and nursing intervention of pulse epidural controlled analgesia on uterine contraction pain after cesarean section.Methods:A total of 100 cases of parturient with patient-controlled epidural analgesia after elective cesarean section in Central Theater General Hospital of the Chinese People's Liberation Army from January to March 2019 were selected as study subjects, and 100 cases were divided into observation group and control group, each group of 50 cases, the control group used constant speed epidural patient-controlled analgesia, the observation group used pulse epidural patient-controlled analgesia. The analgesic effect of uterine contraction pain after cesarean section was observed, at the same time, the two groups conducted a simulation test, the speed, time and infiltration area of the pumping liquid were recorded, and the Visual Analogue Scale (VAS) scores of incision pain and uterine contraction pain were recorded at 6 h, 12 h, 24 h and 48 h postoperatively. VAS score of contraction pain after single press, Motor Block score of iatrogenic uterine pain were recorded on the postoperative day, the first day and the second day after operation.The times of additional dose compression by analgesia pump, the times of incomplete analgesia intervention, nausea and vomiting, skin itching and other adverse reactions were recorded within 2 days after operation.Results:The infiltration area at 1, 5 min were (130.00±14.14), (334.00±2.83) cm 2 in the observation group and (65.00±7.07), (137.50±3.54) cm 2 in the control group, there were significant differences between the two groups( t values were 5.814, 61.376, P< 0.05 or 0.01). VAS scores of incision pain at 6 h and 12 h after operation were (2.36±1.05) and (2.42±0.95) in the observation group and (3.52±1.09) and (3.16±1.25) in the control group, respectively, there were significant differences between the two groups( t values were 5.425, 3.331, P<0.01). VAS scores of uterine contraction pain at 6,12 and 24 hours after operation were (2.66±0.80), (2.23±0.68), (2.22±0.71) in the observation group and (5.14±1.05), (4.48±0.71), (3.36±0.80) in the control group, respectively, there were significant differences between the two groups( t values were 2.489, 2.008, 5.004, P<0.01 or 0.05).VAS scores of contraction pain after single press on the postoperative day, the first day and the second day after operation in the observation group were (2.66±0.80), (2.23±0.68), (2.22±0.71) in the observation group and (5.14±1.05), (4.48±0.71), (3.36±0.80) in the control group, respectively, there were significant differences between the two groups( t values were 13.296,15.536, 7.534, P<0.01). The times of pressing and intervention were (2.28±1.36) and (0.90±0.61) in the observation group and (4.62±1.61), (0.62±0.53) in the control group, respectively, there were significant differences between the two groups( t values were 7.847, 2.439, P<0.01 or 0.05). Maternal satisfaction score was (5.92±1.37) and (2.34±0.82) in the observation group and the control group, there was significant difference ( t value was 15.856, P<0.01).The incidence of adverse reactions such as lower limb numbness, nausea and vomiting and skin pruritus in the observation group were 2.00%(1/50), 4.00%(2/50) and 4.00%(2/50) respectively, which were lower than those in the control group 14.00%(7/50), 16.00%(8/50), 18.00%(9/50), the difference was statistically significant ( χ2 values were 4.759, 4.000, 5.005, P<0.05). Conclusions:The pulse epidural controlled analgesia can effectively reduce the uterine contraction pain after cesarean section, and the active nursing intervention can accelerate the postoperative recovery of parturient.