fa مقایسه شدت درد، طول زایمان و رضایتمندی از زایمان در روش بیحسی با تزریق فنتانیل و آب مقطر در زنان با زایمان طبیعی تخصصي Special كاربردي Applicable <p dir="RTL" style="margin-bottom:6.0pt;text-align:justify;line-height:150%;direction:rtl;unicode-bidi:embed;"><strong><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">زمینه و هدف: </span></span></strong><span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">یکی از دلایل شایع در سزارین انتخابی، ترس مادر از درد زایمان است، از این رو برای کاهش آمار سزارین به زایمان بی</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:12.0pt;">‌</span></span></span></span><span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">درد توجهی ویژه شده است. این</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تحقیق</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">با</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">هدف</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مقایسه تاثیر دو روش </span></span></span>&nbsp;<span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تزریق</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">زیر</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">جلدی</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">آب</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مقطر و تزریق وریدی فنتانیل بر</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">شدت</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">درد، طول</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">رضایت</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:12.0pt;">‌</span></span></span></span><span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مندی</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">از</span></span></span> <span style="color: black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">زایمان انجام گرفت.</span></span></span></p> <p dir="RTL" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:justify;direction:rtl;unicode-bidi:embed;"><strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">روش</span></span></span></strong><strong><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:12.0pt;">‌</span></span></span></span></strong><strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">ها: </span></span></span></strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">در این کارآزمایی بالینی 100</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">زن باردار</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">در</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مرحله</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اول</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">زایمان</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">به</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">صورت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تصادفی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">به</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">دو</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">گروه</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">50</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نفره</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بی</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:12.0pt;">‌</span></span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">حسی با تزریق آب مقطر و بی</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;"><span style="font-size:12.0pt;">‌</span></span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">حسی با تزریق فنتانیل مورد بررسی قرار گرفتند.</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">شدت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">درد</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">ناحیه</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تحتانی</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">کمر</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">قبل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">دقایق</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">10، 45</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">و 90</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">بعد</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">از</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">مداخله</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">در</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">دو</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">گروه</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اندازه گیری گردید.</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">ابزار</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">گردآوری</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">داده‌ها</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">شامل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">پرسشنامه،</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">فرم</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">ثبت</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">اطلاعات مقیاس دیداری درد و پرسشنامه رضایت‌سنجی بود.</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">تحلیل</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">داده‌ها</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">با کمک نرم افزار </span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;">SPSS</span></span></span> <span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نسخه 20 انجام شد.</span></span></span></p> <p dir="RTL" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:justify;direction:rtl;unicode-bidi:embed;"><strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نتایج:</span></span></span></strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> میانگین سنی شرکت کنندگان در گروه بی‌حسی با تزریق آب مقطر و تزریق فنتانیل به ترتیب23/54 و 24/46 سال بود. </span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">شدت درد دقیقه 45 بعد از مداخله و همینطور </span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">طول زمان مرحله اول زایمان در گروه بی‌حسی با آب مقطر به طور معناداری کمتر از گروه بی‌حسی با فنتانیل بود (0/05></span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;">P</span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">)؛ در حالی که </span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">میزان رضایت از زایمان در گروه بی‌حسی با آب مقطر بیشتر از گروه بی‌حسی با فنتانیل بود (0/006=</span></span></span><span dir="LTR"><span style="color:black;"><span style="font-family:times new roman,serif;">P</span></span></span><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">). </span></span></span></p> <p dir="RTL" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:justify;direction:rtl;unicode-bidi:embed;"><strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;">نتیجه‌گیری:</span></span></span></strong><span style="color:black;"><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"> به‌نظر می‌رسد بی‌حسی با آب مقطر در مقایسه با فنتانیل در زنان مراجعه کننده جهت زایمان طبیعی از رضایت بیشتری در بین مادران برخوردار است. همچنین بررسی های بیشتری در این زمینه پیشنهاد می‌گردد.</span></span></span></p> <p><strong><em>Background & Aim</em></strong><em>:</em> One of the common reasons for selecting C-section by mothers is the fear of labor pain. Hence, many attempts have been made to reduce C-section cases and increase painless delivery. Therefore, this study aimed to compare the efficacy of anesthesia with fentanyl injection and anesthesia with water injection on pain intensity, labor duration and satisfaction with labor in women undergoing vaginal delivery.</p> <p><strong><em>Methods</em></strong><strong>:</strong> In this clinical trial, 100 pregnant women in the first stage of labor were randomly divided into two groups of 50 patients undergoing water injection anesthesia and analgesia with fentanyl. Lower back pain was measured before and 10, 45 and 90 minutes after treatment in both groups. Data collection tools include demographic questionnaire, visual Analog scale (VAS), and satisfaction questionnaire. Data were analyzed using SPSS20.</p> <p><strong><em>Results</em></strong><strong>:</strong> The mean age of participants in both groups of anesthesia with fentanyl injection and anesthesia with distilled water injection was 24.46 and 23.54 years, respectively. Satisfaction with anesthesia was significantly higher in distilled water anesthesia group than fentanyl anesthesia group (P =0.006).&nbsp; Pain intensity in minute 45 was significantly lower in the group with distilled water injection than fentanyl anesthesia group (P˂0.05). Moreover, labor duration was significantly lower in the group with distilled water injection than fentanyl anesthesia group after intervention (P˂0.05).</p> <p><strong><em>Conclusion</em></strong><strong>:</strong> It seems that anesthesia with distilled water injection is more welcomed than fentanyl injection among women undergoing vaginal delivery. However, further investigation is needed in this regard.</p> <p style="margin-left:.5in;"></p><p style="margin-left:.5in;"></p> شدت درد, طول زایمان, رضایت‌مندی از زایمان, فنتانیل, آب مقطر Pain intensity, labor duration, satisfaction with labor, fentanyl, distilled water 31 37 http://jms.thums.ac.ir/browse.php?a_code=A-10-29-10&slc_lang=fa&sid=1 Malihe Pashib ملیحه پاشیب PashibM1@thums.ac.ir 10031947532846006543 10031947532846006543 No دانشگاه علوم پزشکی تربت حیدریه Reza Tarjoman Parashkooh رضا ترجمان پرشکوه r_tarjoman@yahoo.com 10031947532846006544 10031947532846006544 No دانشگاه علوم پزشکی تربت حیدریه Fatemeh Sadat Mostafavi فاطمه سادات مصطفوی khalafi.tums@gmail.com 10031947532846006545 10031947532846006545 No Student Research Committee دانشگاه علوم پزشکی تربت حیدریه Seyyed hossein khademi سید حسین خادمی khalafi.tums@gmail.com 10031947532846006546 10031947532846006546 No Torbat Heyadriyeh University of Medical Sciences دانشگاه علوم پزشکی تربت حیدریه Omid Abbasi امید عباسی khalafi.tums@gmail.com 10031947532846006547 10031947532846006547 No Torbat Heyadriyeh University of Medical Sciences دانشگاه علوم پزشکی تربت حیدریه Ali khalafi علی خلفی khalafi.tums@gmail.com 10031947532846006548 10031947532846006548 Yes دانشگاه علوم پزشکی تربت حیدریه