Combined application of intraspinal analgesia, bilateral pudendal nerve block anesthesia and modified perineal protection in midwifery / 中国基层医药

ABSTRACT

Objective:To investigate the clinical efficacy of intraspinal analgesia, pudendal nerve block anesthesia and modified perineal protection in combination in midwifery.Methods:A total of 160 primiparous women who were subjected to full-term vaginal delivery in Suqian Hospital of Nanjing Drum Tower Hospital Group between January 2019 and January 2021 were included in this study. They were randomly assigned to undergo either bilateral pudendal nerve block combined with modified perineal protection (control group, n = 80) or intraspinal analgesia, pudendal nerve block anesthesia and modified perineal protection in combination (observation group, n = 80). Each clinical index was compared between the control and observation groups. Results:Duration of labor in the observation group was significantly shorter than that in the control group [(7.23 ± 2.11) hours vs. (9.35 ± 3.79) hours, t = 4.27, P < 0.05). Cesarean section rate in the observation group was significantly lower than that in the control group [8.7% (7/80) vs. 52.5% (42/80), χ 2 = 17.18, P < 0.05]. Incidence of perineal tears in the observation group was significantly lower than that in the control group [8.7% (7/80) vs. 32.5% (26/80), χ 2 = 15.48, P < 0.05]. Third-degree perineal tears occurred in neither group. Time of postpartum off-bed ambulation and length of postpartum hospital stay in the observation group were (1.37 ± 0.13) days and (3.22 ± 0.31) days, respectively, which were significantly shorter than those in the control group [(2.52 ± 0.22) days, (5.23 ± 0.62) days, t = 25.90, 25.94, both P < 0.05). The incidence of complications in the observation group was significantly lower than that in the control group [7.5% (6/80) vs. 23.7% (19/80), χ 2 = 8.01, P < 0.05]. There were no significant differences in incidence of neonatal asphayxia, 2-hour postpartum hemorrhage and postpartum hemorrhage between the two groups (all P > 0.05). Conclusion:During midwifery of full-term vaginal delivery, combined application of intraspinal analgesia, bilateral pudendal nerve block anesthesia and modified perineal protection can shorten duration of labor and decrease cesarean section rate.