مقایسه تأثیر گاز انتونوکس با لیدوکائین بر علائم حیاتی حین برش و ترمیم اپی‌زیاتومی زنان نخست‌زا: یک کارآزمایی بالینی تصادفی شده

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مامایی، گروه مامایی، دانشکده علوم پزشکی شوشتر، شوشتر، ایران.

2 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

3 کارشناس ارشد مامایی، مرکز تحقیقات ارتقاء سلامت باروری، دانشکده پرستاری و مامایی،‌ دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

چکیده

مقدمه: زایمان حادثه‌ای بالقوه تنش‌زا است. تنش و اضطرابی که مادر در حین زایمان به‌خصوص در موارد نیاز به اپی‌زیاتومی تجربه می‌کند، با تحریک اعصاب سمپاتیک منجر به بروز تغییراتی در علائم حیاتی می‌شود که می‌تواند اثرات نامطلوبی بر سلامت مادر و نوزاد داشته باشد؛ لذا مطالعه حاضر با هدف مقایسه گاز انتونوکس با لیدوکائین بر علائم حیاتی حین برش و ترمیم اپی‌زیاتومی زنان نخست‌زا انجام شد.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 1394 بر 120 زن باردار نخست‌زا انجام شد. در گروه مداخله، گاز انتونوکس از 2 دقیقه قبل از برش و ترمیم اپی‌زیاتومی داده شد و بعد از اتمام برش و ترمیم قطع می‌شد. در گروه کنترل طبق روش معمول از 5 میلی‌لیتر لیدوکائین 2% قبل از برش و ترمیم اپی‌زیاتومی استفاده شد. علائم حیاتی قبل و بعد از برش و ترمیم اپی‌زیاتومی با استفاده از دستگاه پالس‌اکسی‌متر مورد بررسی و مقایسه قرار گرفت. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون‌های من‌ویتنی و کای دو انجام شد. میزان p‌ کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته‌ها: بین میزان نبض، درصد اشباع اکسیژن شریانی قبل و بعد از برش و ترمیم اپی‌زیاتومی، میزان تنفس بعد از برش و قبل از ترمیم اپی‌زیاتومی و میزان فشارخون سیستول و دیاستول قبل و بعد از برش و ترمیم اپی‌زیاتومی در دو گروه تفاوت معنی‌داری وجود نداشت (05/0p>). در دو گروه بین میزان تنفس قبل از برش و بعد از ترمیم اپی‌زیاتومی، تفاوت معنی‌داری وجود داشت (05/0p<). این میزان در گروه انتونوکس بیشتر از لیدوکائین بود. میزان فشار خون دیاستول قبل و بعد از برش اپی‌زیاتومی تفاوت معنی‌داری داشت (05/0p<)، بدین معنا که در گروه انتونوکس کمتر بود. هیچ‌گونه عوارض جانبی مشاهده نشد.
نتیجه‌گیری: گاز انتونوکس همانند لیدوکائین در صورت استفاده صحیح، هیچ‌گونه اثرات جانبی بر علائم حیاتی مادر ندارد.

کلیدواژه‌ها

عنوان مقاله [English]

Effects of entonox in comparison with lidocaine on vital signs during episiotomy incision in nulliparous women: A randomized clinical trial

نویسندگان [English]

  • Azam Honarmandpour 1
  • Masoumeh Yaralizadeh 2
  • Masoumeh Yaralizadeh 3
1 M.Sc. of Midwifery, Department of Midwifery, Faculty Shoushtar of Medical Sciences, Shoushtar, Iran.
2 M.Sc. of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
3 M.Sc. of Midwifery, Fertility Heath Improvement Research Center, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
چکیده [English]

Introduction: Delivery is potentially a stressful event. The maternal stress and anxiety, especially in the need for episiotomy, stimulates sympathetic system and leads to changes in vital signs which can have undesirable effects on maternal and fetal health. Therefore, this study was performed with aim to investigate the effects of entonox in comparison with lidocaine on vital signs during episiotomy incision in nulliparous women.
Methods: This randomized clinical trial was performed on 120 nulliparous women in 215. Intervention group received entonox two minutes before starting episiotomy incision and its repair and was stopped at the end of the incision procedure. Control group as routine received 5 ml lidocaine 2% before starting incision episiotomy. Vital signs were evaluated and compared before and after incision and episiotomy by pulse oximeter. Data were analyzed by SPSS software (version 18) and Mann-Whitney and Chi-square tests. P<0.05 was considered significant.  
Resuts: There was no significant difference between pulse, oxygen saturationbefore and after of incision and repair of episiotomy, respiratory rate after of incision and before of repair episiotomy and systole and diastole blood pressure before and after of incision and repair of episiotomy (P>0.05). There was significant difference between two groups in terms of respiratory rate before incision and after of episiotomy repair (P<0.05). In entonox group, it was more than to lidocaine group. There was significant difference between diastolic blood pressure before and after incision (P<0.05); it was less in entonox group. No side effect was reported.
Conclusion: Eentonox gas same as lidocaine when is used correctly has no adverse effects on mother's vital sign.

کلیدواژه‌ها [English]

  • Entonox
  • Episiotomy
  • Lidocaine
  • Nulliparous women
  • Vital sign

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مجله زنان، مامایی و نازایی ایران
دوره 19، شماره 39
اسفند 1395
صفحه 35-45

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