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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: A two-centre randomised blinded controlled trial
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A comparison of intramuscular diamorphine and intramuscular pethidine for labour analgesia: A two-centre randomised blinded controlled trial

机译：肌内吗啡和哌替啶肌内分娩镇痛的比较：一项两中心随机盲对照试验

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Objective: Intramuscular (i.m.) pethidine is used worldwide for labour analgesia and i.m. diamorphine usage has increased in the UK in the last 15 years. This trial aims to ascertain the relative efficacy and adverse effects of diamorphine and pethidine for labour pain. Design: Prospective, parallel-arm randomised controlled trial with blinding of participants, care-givers and outcome assessors. Setting: Maternity units in two District General Hospitals in the UK. Population: After written informed consent, 484 women were randomised and recruited (244 diamorphine, 240 pethidine). Inclusion criteria included women 16 years or older, established labour, singleton pregnancy, 37-42 weeks of gestation and weight 60-120 kg. Methods: On request of i.m. analgesia, participants received either 150 mg pethidine or 7.5 mg diamorphine based on computer-generated block randomisation. Main outcome measures: Maternal - reduction in pain intensity from baseline (10-cm visual analogue scale) at 60 minutes and over the 3-hour period after drug administration. Neonatal - requirement for resuscitation and Apgar score at 1 minute. Results: Diamorphine provided modestly improved pain relief at 60 minutes, mean difference 1 cm (95% confidence interval [CI] 0.5-1.5), and over the 3 hours, mean difference 0.7 cm (95% CI 0.3-1.1). However, average length of labour in women receiving diamorphine was 82 minutes longer (95% CI 39-124) and therefore they experienced more pain overall. There were no statistically significant differences in primary neonatal outcomes. Conclusions: There is a modest difference between the analgesia provided by diamorphine or pethidine for labour analgesia but diamorphine is associated with significantly longer labours.
机译：目的：肌注（i.m.）哌替啶在世界范围内用于分娩镇痛和i.m.镇痛。在过去的15年中，英国的吗啡使用量有所增加。该试验旨在确定二甲吗啡和哌替丁对劳动痛的相对疗效和不良反应。设计：前瞻性，平行组随机对照试验，参与者，护理人员和结果评估者不知情。地点：英国两个地区综合医院的妇产科。人群：经书面知情同意后，随机抽取了484名妇女（244个二氢吗啡，240个哌替啶）。入选标准包括16岁以上的妇女，分娩的劳动，单胎妊娠，37-42周的妊娠和60-120公斤的体重。方法：应IM要求镇痛，根据计算机生成的区组随机分组，参与者接受了150 mg哌替啶或7.5 mg二氢吗啡。主要预后指标：产妇-给药后60分钟和3小时内从基线（10厘米视觉模拟评分）降低疼痛强度。新生儿-复苏要求和1分钟的Apgar评分。结果：二甲吗啡在60分钟时的疼痛缓解程度有所改善，平均差异为1厘米（95％置信区间[CI] 0.5-1.5），而在3小时内平均差异为0.7厘米（95％CI 0.3-1.1）。但是，接受二氢吗啡的妇女的平均分娩时间延长了82分钟（95％CI 39-124），因此她们总体上会遭受更多的痛苦。新生儿原发结局无统计学差异。结论：二甲吗啡或哌替啶对分娩镇痛的镇痛作用之间存在适度的差异，但乙吗啡与明显更长的分娩时间有关。

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