摘要目的 评价地塞米松局部注射对硬膜外分娩镇痛后腰背痛的预防效果.方法 拟行硬膜外分娩镇痛的初产妇200例,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将其分为2组(n=100):对照组(C组)和地塞米松组(D组).D组于硬膜外穿刺点周围注射利多卡因4 ml和地塞米松1 ml(5 mg)的混合液,C组于硬膜外穿刺点周围注射利多卡因4 ml和生理盐水1 ml的混合液.局部注射后行硬膜外穿刺.根据硬膜外穿刺结果各组再分为单次穿刺亚组和重复穿刺亚组,即C组(Cs亚组和Cr亚组)和D组(Ds亚组和Dr亚组).术后随访,记录分娩镇痛后72 h内腰背痛的发生情况.结果 与C组比较,D组腰背痛的发生率降低,疼痛程度减轻(P＜0.05).与Cs亚组比较,Ds亚组腰背痛发生率降低(P＜0.01).与Cr亚组比较,Dr亚组腰背痛发生率降低(P＜0.01).结论 地塞米松5 mg局部注射有助于减轻硬膜外分娩镇痛后腰背痛.

abstractsObjective To evaluate the efficacy of locally administered dexamethasone for prevention of low back pain after labor epidural analgesia.Methods Two hundred nulliparous parturients who required labor epidural analgesia,of ASA physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n =100 each) using a random number table:control group (group C) and dexamethasone group (group D)).In group D,lidocaine 4 ml and dexamethasone 1 ml (5 mg) were injected around the puncture site.In group C,lidocaine 4 ml and normal saline 1 ml were injected around the puncture site.Epidural puncture was performed after local administration.According to the results of epidural puncture,each group was further divided into two subgroups:single puncture group (Cs subgroup,Ds subgroup) and repetitive puncture group (Cr subgroup,Dr subgroup).The patients were followed up for 72 h,and the development of low back pain was recorded.Results Compared to group C,the incidence of low back pain was significantly decreased,and pain was reduced in group D.The incidence of low back pain was significantly lower in Ds group than in Cs group,and in Dr group than in Cr group.Conclusion Locally administered dexamethasone 5 mg is helpful in reducing low back pain after labor epidural anesthesia.