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一、产痛发生机制:(1)颈管的扩大。目前认为子宫颈管的开大所引起的内脏痛为主要因素,其理由为:①子宫口的开大程度与产痛强弱有极密切的关系。②在非麻醉状态下扩张子宫颈管,受术者不论妊娠与否均感到和分娩时同样的疼痛,表现在下腹部和腰部。③将小气囊插入子宫颈管,使其膨胀后,可引起下腹部痉挛性强烈疼痛。④子宫颈管平滑肌伸展所产生内脏痛,能在相应的皮肤反映出皮肤疼痛。⑤子宫收缩后,并不立刻感知痛觉,而是在15～30秒才出现,这可能是由于子宫收缩使羊水压力不断增高,增至一定压力(25mmHg)以上,子宫下部及子宫口伸展而感觉到疼痛。⑥在腹壁局部浸润麻醉下行正中切开术暴露子宫,子宫
First, the mechanism of occurrence of pain: (1) enlargement of the neck. At present, the main reason for the visceral pain caused by the opening of the cervical canal is the following reasons: (1) The degree of opening of the uterine cervix is closely related to the strength of labor. ② In the non-anesthetic state to expand the cervical canal, regardless of pregnancy by the operation and feel and childbirth the same pain, manifested in the lower abdomen and waist. ③ small balloon inserted into the cervical canal, so that after expansion, can cause severe abdominal pain spasm. ④ cervical canal smooth muscle stretching visceral pain, can reflect the skin of the corresponding skin pain. ⑤ contraction of the uterus, the pain is not immediately perceived, but only 15 to 30 seconds to appear, which may be due to uterine contractions make amniotic fluid pressure increased to a certain pressure (25mmHg) above the lower part of the uterus and cervix stretch feeling To pain. ⑥ local infiltration anesthesia in the abdominal incision under the middle incision exposed uterus, uterus