NGHIÊN CỨU ỨNG DỤNG PHƯƠNG PHÁP GÂY TÊ NGOÀI MÀNG CỨNG ĐỂ GIẢM ĐAU CHUYỂN DẠ CHO SẢN PHỤ SINH THƯỜNG TẠI BỆNH VIỆN SẢN-NHI TỈNH QUẢNG NGÃI

Abstract

Background: Epidural analgesia is a commonly used method of pain relief in labor in many obstetrics hospitals, brings various benefits and avoids unnecessary cesarean sections. Epidural anesthesia with Bupivacain and Fentanyl has been used during labor in our hospital and not evaluated yet. Objectives: To evaluate the effectiveness of pain relief, adverse effects and maternal satisfaction with epidural analgesia during labor. Methods: This was a cross-sectional study on pregnant women reporting from January to October 2020 at Quang Ngai Hospital for Women and Children. The woman aged 18-40 years, classified as American Society of Anesthesiologists score I and II who requested epidural analgesia in active labor were taken for this study. Women with any contraindications to epidural techniques were excluded. Results: Out of 326 pregnant women, the figure for mean weight and height was 60,04±7,59 kg and 159,07±7,71 cm respectively. The efficacy of analgesia: the mean time of onset of analgesia was 5,77±1,35 minutes. Visual analog scale: Before epidural injection, VAS score was 7,15±1,28. After 5 minutes of epidural anesthesia and in subsequent evaluation periods, the VAS score decreased to under 4. Maternal adverse effects: We found no significant alterations with regard to maternal SpO2 values, pulse, blood pressure and fetal heart rate. There were several clinical adverse effects such as hypotension, headache, shivering, nausea and vomiting, urinary retention. 30,68% of patients reported it as a very good experience and satisfied with the procedure. Conclusion: Epidural anesthesia is an efficient way of pain relief during labor and delivery: Before epidural injection, VAS score was more than 7. In subsequent evaluation periods, the VAS score was under 4. There were no significant alterations in terms of fetal heart rate and respiratory rate of the pregnants. Adverse effects and complications were not noted.