Journal of Rafsanjan University of Medical Sciences
مجله دانشگاه علوم پزشکی رفسنجان
JRUMS
Medical Sciences
http://journal.rums.ac.ir
69
journal69
1735-3165
2008-7268
10.66224/jrums
fa
jalali
1402
8
1
gregorian
2023
11
1
22
8
online
1
fulltext
fa
تأثیر زایمان بیدرد با بلوک سدل بر برخی پارامترهای زایمان در زنان نخستزا: یک مطالعه کارآزمایی بالینی
Effect of Painless Delivery with Saddle Block on Some Labor Parameters in Primiparous Women: A Clinical Trial Study
بيهوشي
Anesthesiology
پژوهشي
Research
<span style="font-size:10pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><a name="_Hlk113374001"><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">زمینه و هدف: </span></span></span></b></a><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">درد زایمان غیرقابل تحملترین درد است که میتوان آن را با روشهای بیدردی تسکین داد. این مطالعه با هدف تعیین تأثیر تزریق سوفنتانیل داخل نخاعی بر برخی پارامترهای زایمان در زنان نخستزا انجام شد.</span></span></span><i></i></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">مواد و روشها:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""> در این مطالعه کارآزمایی بالینی 126 زن نخستزا کاندید زایمان طبیعی از تاریخ 15/9/1399 در بخش لیبر زایشگاه نیک نفس </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">رفسنجان وارد مطالعه شدند و بر اساس جدول اعداد تصادفی در گروه مداخله و کنترل بهطور مساوی قرار گرفتند. گروه مداخله دوز 1/0 میکروگرم/کیلوگرم سوفنتانیل در فضای </span></span></span>L5-S1<span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""> دریافت و گروه کنترل، زایمان بیدرد دریافت نکرد. سپس طول مرحله اول زایمان، نمره شدت درد، پارگی پرینه، فراوانی سزارین، رضایتمندی مادر، آپگار نوزاد، زایمان با وکیوم و</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">نیاز به مسکن در دو گروه بررسی شد. جهت مقایسه متغیرهای کمی در دو گروه از آنالیز واریانس دوطرفه با اندازهگیریهای مکرر و جهت مقایسه متغیرهای کیفی از آزمون مجذور کای استفاده شد. </span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">یافته­ها:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""> میانگین و انحراف معیار طول اولین مرحله زایمان در گروه مداخله و کنترل به ترتیب 43/58 </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"Cambria","serif"">±</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""> 33/141 و 81/140 </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"Cambria","serif"">±</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""> 61/278 دقیقه بود که این اختلاف از نظر آماری معنیدار بود</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""> (001/0></span></span></span>P<span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">). میانگین نمره درد، تعداد موارد پارگی پرینه، تعداد موارد منجر به سزارین و فراوانی نیاز به مسکن در گروه مداخله بهطور معنیداری کمتر از گروه کنترل بود (05/0></span></span></span>P<span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">). </span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">نتیجه­گیری:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""> زایمان بی­درد با بلوک سدل و داروی سوفنتانیل طول مرحله اول و نمره شدت درد زایمان را کاهش داد و سایر پارامترهای زایمانی</span></span></span> <span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">را بهبود بخشید. بنابراین، بلوک سدل برای انجام بیدردی زایمان پیشنهاد می­شود.</span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:115%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin"">واژههای کلیدی:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""> زایمان بیدرد، زن نخستزا، بلوک سدل، سوفنتانیل</span></span></span><span lang="AR-SA" style="font-size:1.0pt"><span style="line-height:115%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><a name="_Hlk114425361"><b><span style="font-size:9.0pt"><span style="line-height:150%">Background and Objectives:</span></span></b></a><span style="font-size:9.0pt"><span style="line-height:150%"> Labor pain is the most unbearable pain and can be relieved by painless delivery. This study aimed at investigating the effect of intrathecal sufentanil on some labor parameters in primiparous women.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:9.0pt"><span style="line-height:150%">Materials and Methods:</span></span></b><span style="font-size:9.0pt"><span style="line-height:150%"> In this clinical trial study, 126 primiparous women, who were candidates for vaginal delivery in Niknafs Hospital of Rafsanjan, were enrolled based on the table of random numbers in two intervention and control groups equally. The intervention group received 0.1 µg/kg sufentanil in the L5-S1 space, and the control group did not receive painless delivery. Then, the length of the first stage of labor, pain score, perineal laceration, frequency of cesarean section, mother's satisfaction, Apgar of neonate, delivery with vacuum, and need for analgesic in postpartum period were investigated. To compare numeric variables, two-way repeated measures analysis of variance (ANOVA), and to compare the categorical variables chi-square test were used.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:9.0pt"><span style="line-height:150%">Results:</span></span></b><span style="font-size:9.0pt"><span style="line-height:150%"> The average length of the first stage of labor in the intervention and control groups were 141.33±58.43 and 278.61±140.81 minutes, respectively, and the difference was statistically significant (p<0.001). In the intervention group, average pain score, perineal laceration, cases leading to caesarean section, and</span></span><b> </b><span style="font-size:9.0pt"><span style="line-height:150%">the frequency of need for analgesic in postpartum were significantly less than the control group (p<0.05).</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:9.0pt"><span style="line-height:150%">Conclusion:</span></span></b><span style="font-size:9.0pt"><span style="line-height:150%"> Painless delivery with saddle block and sufentanil drug reduced length of the first stage of delivery and pain score. Also it</span></span><b> </b><span style="font-size:9.0pt"><span style="line-height:150%">improved other delivery parameters, so it is recommended for painless delivery.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:9.0pt"><span style="line-height:150%">Key words: </span></span></b><span style="font-size:9.0pt"><span style="line-height:150%">Painless delivery, Primiparous, Saddle block, Sufentanil</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><span style="font-size:9.0pt"><span style="line-height:150%"></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:9.0pt"><span style="line-height:150%">Funding: </span></span></b><span style="font-size:9.0pt"><span style="line-height:150%">This study was funded by Rafsanjan University of Medical Sciences.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:9.0pt"><span style="line-height:150%">Conflicts of interest: </span></span></b><span style="font-size:9.0pt"><span style="line-height:150%">None declared.</span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:9.0pt"><span style="line-height:150%">Ethical approval: </span></span></b><span style="font-size:9.0pt"><span style="line-height:150%">The Ethics Committee</span></span><b> </b><span style="font-size:9.0pt"><span style="line-height:150%">of Rafsanjan University of Medical Sciences approved the study (IR.RUMS.REC.1399.207).</span></span><b><span dir="RTL" lang="FA" style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><i><span lang="EN" style="font-size:2.0pt"><span style="line-height:150%"></span></span></i></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:9.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:150%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:9.0pt"><span style="line-height:150%">How to cite this article:</span></span></b><span style="font-size:9.0pt"><span style="line-height:150%"> Jadidi Fatemeh, Amin Reza, Esmaeili Fatemeh, Bazmandegan Gholamreza. Effect of Painless Delivery with Saddle Block on Some Labor Parameters in Primiparous Women: A Clinical Trial Study</span></span><span lang="EN" style="font-size:9.0pt"><span style="line-height:150%">. </span></span><i><span style="font-size:9.0pt"><span style="line-height:150%">J Rafsanjan</span></span></i><span style="font-size:9.0pt"><span style="line-height:150%"> <i>Univ Med Sci</i> 2023; 22 (8): 789-804. [Farsi]</span></span> <b><span style="font-size:8.0pt"><span style="line-height:150%"></span></span></b></span></span></span></span></span><br>
زایمان بیدرد, زن نخستزا, بلوک سدل, سوفنتانیل
Painless delivery, Primiparous, Saddle block, Sufentanil
789
804
http://journal.rums.ac.ir/browse.php?a_code=A-10-1981-4&slc_lang=fa&sid=1
Fatemeh
Jadidi
فاطمه
جدیدی
fa.jadidi.2020@gmail.com
6900319475328460055633
6900319475328460055633
Yes
Rafsanjan University of Rafsanjan
دانشگاه علوم پزشکی رفسنجان
Reza
Amin
رضا
امین
6900319475328460055634
6900319475328460055634
No
Rafsanjan University of Rafsanjan
دانشگاه علوم پزشکی رفسنجان
Fatemeh
Esmaieli
فاطمه
اسماعیلی
6900319475328460055635
6900319475328460055635
No
Rafsanjan University of Rafsanjan
دانشگاه علوم پزشکی رفسنجان
Golamreza
Bazmandegan
غلامرضا
بازماندگان
6900319475328460055636
6900319475328460055636
No
Rafsanjan University of Rafsanjan
دانشگاه علوم پزشکی رفسنجان