社会心理因素对硬膜外麻醉剖宫产初产妇术中疼痛的影响

摘要

目的 探讨社会心理因素对硬膜外麻醉剖宫产初产妇术中疼痛的影响.方法 选择择期行硬膜外麻醉剖宫产的初产妇200例,收集人口学资料.术前对产妇进行生活满意度、社会支持度评估,术中采用视觉模拟评分法评估患者术中疼痛程度,应用logistic回归模型分析硬膜外麻醉剖宫产产妇术中疼痛的影响因素.结果 术中27例剖宫产产妇发生疼痛,占13.5%.疼痛及非疼痛产妇的社会支持度分别为21～38(28.11 ± 5.92)分、21～53(38.61 ± 6.80)分;疼痛及非疼痛产妇的生活满意度分别为7～32(24.93 ± 7.94)分、7～34(29.58 ± 3.94)分.Logistic回归模型分析结果显示,生活满意度和社会支持度是硬膜外麻醉剖宫产产妇术中疼痛的保护因素(P＜0.05).结论 生活满意度和社会支持度与硬膜外麻醉剖宫产初产妇术中疼痛发生相关,提高患者生活满意度和社会支持度可以减少初产妇术中疼痛发生.%Objective To explore the impacts of psychosocial factors on intraoperative pain in the primiparas undergoing cesarean section with epidural anesthesia.Methods A total of 200 primiparas undergoing epidural anesthesia for cesarean section were enrolled. The demographic data were collected.Life satisfaction and social support were assessed in the primiparas before operation.The severity of intraoperative pain was evaluated using Visual Analogue Scale.Logistic regression model was used to analyze the factors influencing intraoperative pain in the primiparas undergoing cesarean section with epidural anesthesia. Results Twenty-seven cases suffered from intraoperative pain,accounting for 13.5%.The scores for social support of the primiparas with pain and without pain were 28.11 ± 5.92(range,21-38) and 38.61 ±6.80(range,21-53) respectively.The scores for life satisfaction of the primiparas with pain and without pain were 24.93 ± 7.94 (range,7-32) and 29.58 ± 3.94(range,7-34) respectively.The result of logistic regression model analysis showed that life satisfaction and social support were the protective factor for intraoperative pain in the primiparas undergoing cesarean section with epidural anesthesia (P＜0.05).Conclusion Life satisfaction and social support are related to the incidence of intraoperative pain in the primiparas undergoing cesarean section with epidural anesthesia. Improvement of patients′ life satisfaction and social support may reduce the incidence of intraoperative pain in primiparas.