Women's Health Nursing (여성건강간호학회지)

Korean Society of Women Health Nursing (한국여성건강간호학회)
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Comparison of Obstetric Pain, Anxiety, and Cervical Dilatation between Epidural Analgesia and No Analgesia group during Labor Stage I

경막외 마취제 투여 유무에 따른 분만 1기 산부의 분만 통증, 불안, 자궁경관 개대 정도 비교

  • 한수정 (순천향대학교 부천병원 분만실) ;
  • 김증임 (순천향대학교 간호학과) ;
  • 김묘진 (순천향대학교 부천병원 분만실)
  • Received : 2012.05.31
  • Accepted : 2012.06.18
  • Published : 2012.06.20
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Abstract

Purpose: This research was done to compare obstetric pain, anxiety and cervical dilatation between an epidural analgesia group and a control group. Methods: Participants were assigned to the experimental or control group depending on their decisions for pain relief. Subjective / objective obstetric pain, anxiety level and cervical dilatation were measured and ANOVA was used for comparison of groups and paired t-test to make pre-post comparisons. Results: Homogeneity of pain, anxiety and cervical dilatation were assessed at the latent phase. Cervical dilatation was larger in the control group than the experimental group, at both the active and the transitional phase (F=22.9, p<.001; F=39.9, p<.001 respectively). The degree of pain and anxiety were not significantly different between the groups. Within the experimental group, subjective / objective pain and anxiety level were significantly lower post-analgesia compared to pre-analgesia in the active phase. All variables, except for sweating in the objective pain measurement, changed significantly at the transient phase. Conclusion: The results of this evidence-based research indicate that epidural analgesia while effective in relieving pain and anxiety may have an adverse effect on the cervix during labor stage I. Epidural analgesia should be used carefully during cervical dilatation in labor stage I.

Keywords

References

  1. Ahn, S. H., Ryu, G. S., & Chung, E. S. (2003). Differences in physical discomfort and childbirth satisfaction between primiparous women with and without having taken epidural analgesia. Korean Journal of Women Health Nursing, 9, 235-244.
  2. Alexander, J. M., Sharma, S. K., McIntire, D. D., & Leveno, K. J. (2002). Epidural analgesia lengthens the Friedman active phase of labor. Obstetrics and Gynecology, 1, 46-50.
  3. Alipour, Z., Lamyian, M., & Hajizadeh, E. (2011). Anxiety and fear of childbirth as predictors of postnatal depression in nulliparous women. Women and Birth, September 27 . [Epub ahead of print]. Retrieved Feb 23, 2012, from http://www. ncbi.nih.gov/pubmed/21959041
  4. Anim-Somuah, M., Smyth, R.,, Howell, C., & Editorial Group: Cochrane pregnancy and childbirth group(2009). Epidural versus non-epidural or no analgesia in labour. http://dx. doi.org/10.1002/14651858
  5. Beijers, R., Jansen, J., Riksen-Walraven, M., & de Weerth, C. (2010). Maternal prenatal anxiety and stress predict infant illnesses and health complaints. Pediatrics, 126, e401-e409. https://doi.org/10.1542/peds.2009-3226
  6. Chestnut, D. H. (1997). Epidural analgesia and the incidence of cesarean section. Anesthesiology, 87, 472-476. https://doi.org/10.1097/00000542-199709000-00003
  7. Diego, M., Jones, N., Field, T., Hernandez-Rief, M., Schanberg, S., Kuhn, C., et al. (2006). Maternal psychological distress, prenatal cortisol, and fetal weight. Psychosomatic Medicine, 68, 747-753. https://doi.org/10.1097/01.psy.0000238212.21598.7b
  8. Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
  9. Han, D. W., Lee, C. H., & Tak, J. G. (1993). Standardization of statetrait anxiety inventory. HaksaengJidoYeongu, 10, 214-222.
  10. Hawkins, J. L. (2010). Epidural analgesia for labor and delivery. New England Journal of Medicine, 362, 1503-1510. https://doi.org/10.1056/NEJMct0909254
  11. Kim, S. J., Choi, P. S., Jeon, H. S., Hong, H. J., & Chung, D. Y. (2001). A study of the effects of epidural analgesia on the course of labor and delivery mode. Korean Journal of Obstetrics & Gynecology, 43, 1783-1789.
  12. Kim, S. Y., Kim, J. H., Kang, Y. I., Kim, M. H., Bang, E. C., Lee, H. S., et al. (2000). Effect of obstetric epidural anesthesia on the progress of labor. Korean Journal of Obstetrics & Gynecology, 43, 2215-2219.
  13. Korean Society of Obstetrics and Gynecology. (2007). Obstetrics (4th ed). Seoul: Koonja.
  14. Kukulu, K., & Demirok, H. (2008). Effects of epidural anesthesia on labor progress. Pain Management Nursing, 9, 10-16. https://doi.org/10.1016/j.pmn.2007.09.003
  15. Lang, A. J., Sorrell, J. T., Rodgers, C. S., & Lebeck, N. M. (2006). Anxiety sensitivity as a predictor of labor pain. European Journal of Pain, 10, 263-270. https://doi.org/10.1016/j.ejpain.2005.05.001
  16. Lee, J. J. (2001). Effect of relaxation on pain and anxiety during insertion of a vaginal speculum. Unpublished master's thesis, Keimyung University, Daegu
  17. Lee, S. W., Yang, J. H., Cho, H. J., Hong, D. S., Kim, M. Y., Ryu, H. M., et al. (2007). The effects of epidural analgesia on labor progress and perinatal outcomes. Korean Journal of Obstetrics & Gynecology, 50, 1330-1335.
  18. Lowdermilk, D., & Perry, S. E. (2004). Maternity and women's health care (8th ed.). St. Louis: Mosby.
  19. McLachlan, E. (1974). Recognizing pain. American Journal of Nursing, 74, 496-497.
  20. National Collaboration Center for Women's and Children's Health. (2007). Intrapartum care: Care of healthy women and their babies during childbirth. NICE clinical guidelines, No. 55. London; RCOG Press. ISBN-13: 978-1-904752-36-3. Retrieved Nov 09, 2011, from http://www.nice.org.uk/ nicemedia/ pdf/CG55FullGuideline.pdf
  21. Poole, J. H. (2003). Analgesia and anesthesia during labor and birth: Implications for mother and fetus. Journal of Obstetric, Gynecologic and Neonatal Nursing, 6 , 780-793.
  22. Saito, M., Okutomi, T., Kanai, Y., Mochizuki, J., Tani, A., Amano, K., et al. (2001). Patient-controlled epidural analgesia during labor using ropivacaine and fentanyl provides better maternal satisfaction with less local anesthetic requirement. Journal of Anesthesia, 19, 208-212. http://dx.doi.org/10.1007/ s00540-005-0316-2
  23. Smith, C. A., Levett, K. M., Collins, C. T., & Crowther, C. A. (2011).Relaxation techniques for pain management in labor. Cochrane Database Systematic Review, 7, CD 009514.
  24. Smith, C. A., Levett, K. M., Collins, C. T., & Jones, L. (2012). Massage, reflexology and other manual methods for pain management in labor. Cochrane Database Systematic Review, 15, CD009290.
  25. Spielberger, C. D. (1975). Anxiety as an emotional state: current trend in theory and research (Vol 1). New York: Academic Press.
  26. Sun, W. H., Choi, H. M., & Kim, J. W. (2003). The influence of epidural anesthesia on the progress of labor and perinatal outcomes. Journal of Obstetrics and Gynecology, 46, 1099- 1103.
  27. Wong, C. A. (2010). Advances in labor analgesia. International Journal of Women's Health, 1, 139-154.
  28. Yoshioka, T., Yeo, S., & Fetters, M. D. (2012). Experiences with anesthesia of Japanese women who had childbirth in the United States. Retrieved Feb 23, 2012, from http://www. ncbi.nih.gov/pubmedhealth/

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