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首页> 外文期刊>International journal of obstetric anesthesia >The effects of meperidine and epidural analgesia in labor on maternal heart rate variability.
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The effects of meperidine and epidural analgesia in labor on maternal heart rate variability.

机译：哌替啶和硬膜外分娩镇痛对产妇心率变异性的影响。

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BACKGROUND: Epidural and parenteral opioid analgesia are two common methods of pain relief in labor that may influence the autonomic nervous system. However, these effects on laboring women have not yet been adequately studied. The aim of our study was to assess the effects of these two methods of analgesia on autonomic nervous system modulation of maternal heart rate variability in laboring women. METHODS: A prospective observational study was conducted on 64 laboring women; 33 received epidural analgesia with bupivacaine and fentanyl and 31 intravenous meperidine and promethazine. Power spectral analysis and nonlinear methods were applied to digitized electrocardiograms performed before and after administration of analgesia, to assess maternal heart rate variability and autonomic equilibrium. RESULTS: Maternal heart rate significantly increased in women who received meperidine compared to those who had epidural analgesia. There was a significant increase in the low-frequency to high-frequency ratio (3.7+/-3.9 vs. 1.8+/-1.6, P<0.05), and a significant decrease of high-frequency spectral power in women who had meperidine compared to those who received epidural analgesia (163+/-91 vs. 98+/-100 ms(2)/Hz, P<0.05). CONCLUSIONS: Meperidine caused an autonomic nervous system shift towards sympathetic activation with abolition of respiratory sinus arrhythmia high-frequency spectral band. Conversely epidural analgesia had no significant effect on autonomic nervous system control of heart rate.
机译：背景：硬膜外和肠胃外的阿片类镇痛是分娩中减轻疼痛的两种常见方法，可能会影响植物神经系统。但是，这些对劳动妇女的影响尚未得到充分研究。我们研究的目的是评估这两种镇痛方法对劳动妇女产妇自主性神经系统调节产妇心率变异性的影响。方法：对64名劳动妇女进行了一项前瞻性观察研究。 33例患者接受布比卡因和芬太尼硬膜外镇痛，31例静注哌啶和异丙嗪。将功率谱分析和非线性方法应用于镇痛前后的数字化心电图，以评估产妇的心率变异性和自主神经平衡。结果：与进行硬膜外镇痛的妇女相比，接受哌替啶的妇女的母亲心率显着提高。与哌替啶相比，低频与高频之比显着增加（3.7 +/- 3.9对1.8 +/- 1.6，P <0.05），并且高频频谱功率显着下降接受硬膜外镇痛的患者（163 +/- 91对98 +/- 100 ms（2）/ Hz，P <0.05）。结论：哌替啶引起自主神经系统向交感神经激活转移，并消除了呼吸窦性心律不齐的高频频谱。相反，硬膜外镇痛对自主神经系统心率的控制没有明显影响。

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