무통분만의 실태보고 (제1보)

Abstract

This report is a clinical analysis of 525 cases of continuous epidural analgesia for labor and delivery during the period of January to October 1985. An epidural puncture is made at the level between L3-4 with the same, techniques as used for an ordinary epidural anesthesia. The catheter was threaded through an 18 G Tuohy epidural needle. During the first stage of labor, 7－8ml of 1% lidocaine mixed with epinephrine (1 : 300, 000) was injected through the catheter when the cervix is 5－6㎝ dilated in primiparas and 4－5㎝ dilated in multiparas. After the initial injection, the same dose of 1% or 1.5% lidocaine was repeated as needed when pain recurred. For the second stage of labor, 10－12ml of 1.5% lidocaine was used. According to our experiences we obtained the following Results ; 1) There are little adverse reactions on mothers and fetuses with our total doses of lidocaine used for analgesia during the labor and delivery. 2) The lidocaine is very fair in price and we can afford it to the practice. 3) The number of parturients have increased since we have practiced painless delivery. 4) Continuous epidural analgesia for labor is benificial to most of the parturients and is highly useful for practice in Korea.

1985년 1월부터 지속적 경막외마취하에 무통분만을 시도하여 10개월간 시술된 525명의 산모를 대상으로 임상적 분석의 경과 다음과 같은 결론을 얻었다. 1) 본원에서 사용한 Lidocaine의 용량으로는 태아와 산모에게 미치는 임상적인 부작용은 볼 수 없었다. 2) Lidocaine을 경막외 마취제로 사용하여 경제적 부담이 적고 쉽게 구입할 수 있어 대중화 될 수 있는 좋은 조건이라고 생각하였다. 3) 무통분만 시술 이후 산모의 입원수가 증가하는 경향을 나타냈으며 산모들의 호응도가 높았다. 4) 통계적 분포로 보아 병원 내용을 잘아는 의사간호원, 병원직원등이 비례적으로 많음을 보아 본시술이 병원직원에게 인정을 받고 있음을 시사하였다.