Avtor/Urednik		Kern, Aleksandra; Jurekovič, Vlado
Naslov		Porodna področna analgezija v SB Jesenice v letu 2006
Prevedeni naslov		Obstetric regional analgesia in the Jesenice general hospital in year 2006
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 76, št. 11
Leto izdaje		2007
Obseg		str. 745-51
Jezik		slo
Abstrakt		Background The aim of this retrospective analysis of the obstetric regional analgesia (ORA) in Jesenice General Hospital in year 2006 was to evaluate our work and present results. We analysed workload, quality of the analgesia and patients’ satisfaction. We also estimated the OR for vacuum extraction (VE) in nulliparous labouring women having ORA. We compared quality of analgesia and total local analgesic consumption in nulliparous women having VE or spontaneous delivery. Methods We performed retrospective analysis of labours with ORA in year 2006. All women received epiduraly mixture of 0.1 % bupivacaine with 2 µg of fentanyl per ml in intermittent boluses.The labour pain was assessed using visual analogue scale (VAS). We used median and interquartile range to describe distribution of these values and mean with standard deviation to describe distribution of other data (local anaesthetic consumption). We considered patient with pain VAS 3 or less adequately treated, VAS 4 and 5 sufficiently and VAS 6 and more insufficiently treated. We used odds ratio as measurement of risk for VE, t-test for differences in local anaesthetic consumption and Mann-Whitney test to evaluate differences in pain between tested groups. Results 225 labouring women opted for ORA or 38% of all labouring women in year 2006. We performed 224 ORA, 59% during regular work, 41% during turn of duty. 18% of ORA were performed between 10 p.m. and 7.00 a.m. In 98% of cases epidural analgesia was used. Anaesthesiologic work took 16 minutes in average (SD 6.06). Analgesia was started at VAS median 5 (IQR 4‐6.5) and at average cervical dilatation 4.1 cm (SD 1.4). Average consumption of bupivacaine was 55 mg (SD 23.7) and fentanyl 91.7 µg (SD 46.5). Most common complications were inadequate analgesia, and misplacement of epidural catheter (10/222), dural tap (6/222), and unilateral analgesia (2/222). (Abstract truncated at 2000 charactes)
Izvleček		Izhodišča V prispevku smo predstavili lajšanje porodne bolečine s porodno področno analgezijo (PPA) v SB Jesenice v letu 2006, delovno obremenitev anesteziologov, učinkovitost in uspešnost analgezije ter zadovoljstvo porodnic. Ocenili smo tudi tveganje za dokončanje poroda z vakuumsko ekstrakcijo ploda (VE) pri porodnicah s PPA ter primerjali analgezijo in porabo lokalnega anestetika (LA) pri prvesnicah s PPA, katerih porod se je končal z VE ali brez. Metode Prispevek je retrospektivna analiza porodov s PPA v letu 2006. Vse porodnice so prejele enako epiduralno analgetično mešanico 0,1% bupivakaina z 2 µg fentanila v ml. Zdravilo so prejemale v posameznih odmerkih. Porodnice smo anketirali dan po porodu. Ocenjevale so povprečno bolečino med porodom ter zadovoljstvo s PPA. Bolečino smo ocenjevali z vizualno analogno lestvico (VAS), porazdelitev vrednosti smo povzeli z mediano in interkvartilnim razmikom (IKR). Druge podatke smo povzeli z aritmetično sredino in standardnim odklonom (SD). Kot ustrezno analgezijo smo opredelili povprečno bolečino med porodom VAS 3 in manj, kot zadostno VAS 4 in 5, kot nezadostno pa VAS 6 in več. Za oceno tveganja za instrumentalno dokončanje poroda smo uporabili razmerje obetov, za oceno razlik v porabi lokalnega anestetika t-test, za oceno razlik v bolečini med skupinami pa test Manna in Whitneya. Rezultati V letu 2006 je porodno regionalno analgezijo izbralo 225 porodnic ali 38% vseh, ki so rodile v SB Jesenice. Opravljenih je bilo 224 PPA, 59% vseh opravljenih PPA smo opravili v rednem delu, 41% pa v času dežurne službe. V nočnem času (med 22.00 in 7.00) je bilo potrebno opraviti 18% vseh PPA. V 98% smo uporabili epiduralno analgezijo. Anesteziološki del izvedbe PPA je trajal 16 min (SD 6,06). (Izvleček prekinjen pri 2000 znakih)
Deskriptorji		LABOR ANALGESIA, EPIDURAL ANALGESIA, OBSTETRICAL PAIN VACUUM EXTRACTION, OBSTETRICAL