Efficiency of opioid analgesia in labor

详细

Objective: Labor is a unique physiological process accompanying with a pain. Hence adequate analgesia in labor is the important factor of regulation of delivery. However, despite of physiologically substantiated opioid analgesia the efficiency in labor is small. The purpose of work was the definition of the factors influencing efficiency opioid analgesia of different groups.

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Methods: The estimation of efficiency of analgesia was carried out on a visual - analog scale of a pain before and after analgesia in labor, circulation of the mother was estimated on the computer integrated impedansometry. The statistical analysis carried out on a standard technique. 4 groups surveyed are allocated. 1-st group 38 Promedol analgesed parturients; 2-d group 40 women analgesed with Fentanyl; 3-d group 46 Tramal parturients; 4-th 36 women received Moradol.

Results: In all groups surveyed 100% analgesia was not revealed. In 1-st group complete analgesia has made 32%, satisfactory analgetic effect is received in 63%, in 2-d group 15% and 72% accordingly, in 3-d group 11% and 59%, and in 4-th - 17% and 63%. The analysis of hemodynamics has shown, that was most effective analgesia at a hypodynamic type of circulation at which parameters of CI, Q, CV, GPR were authentically below, then following sizes: CI 2.5 ± 0.2/min/m²; Q 4.7 ± 1.5/min; CV 56 ± 3.2 ml; GPR 1447 ± 72 din/sm/5 sec.

Conclusions: The various efficiency of the opioid analgesia in labor apparently is connected to a type of hemodynamics at the women and depends about features of influence of opioids on opioid receptors and antinociceptic system as a whole.