Efficacy of programmed intermittent epidural bolus for labor analgesia in parturients and the effect on neonates
10.3760∕cma.j.issn.0254-1416.2016.09.024
- VernacularTitle:程控硬膜外间歇脉冲注入技术用于产妇分娩镇痛的效果及其对新生儿的影响
- Author:
Zhaohui WANG
;
Shiqin XU
;
Shanwu FENG
;
Ruifeng QIAN
;
Xiaofeng SHEN
- Keywords:
Analgesia,epidural;
Analgesia,obstetrical;
Analgesia,patient-controlled
- From:
Chinese Journal of Anesthesiology
2016;36(9):1134-1137
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of programmed intermittent epidural bolus ( PIEB) for labor analgesia in parturients and the effect on neonates. Methods Two hundred primiparae with a sin?gleton fetus in vertex presentation, who requested labor analgesia, aged 21-36 yr, at 37 to 40 week gesta?tion, with cervical dilatation 1-3 cm, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, were divided into 2 groups ( n=100 each) using a random number table: PIEB group and continuous epi?dural infusion ( CEI) group. PIEB regimens were programmed as 10 ml∕h starting from 1 h after the initial bolus. The programmed bolus dose was fixed at 5 ml with the lock?out interval set at 30 min. The drugs used in the analgesic pump were 0?08% ropivacaine and 0?4μg∕ml sufentanil in both groups. From the on?set of labor analgesia until 1 h after delivery, visual analog scale score was used to evaluate the uterine con?traction pain every hour. The modified Bromage score was used to assess the degree of motor block. The up?per spread of sensory block, total consumption of drugs, the number of attempts, duration of every stage, delivery mode, postpartum hemorrhage volume, and occurrence of adverse reactions ( dyspnea, hypoten?sion, pruritus, nausea, vomiting and urinary retention) were recorded. Apgar scores of the neonates were recorded, and the degree of primiparae′satisfaction with the analgesic efficacy was scored. Results Com?pared with group CEI, visual analog scale scores at T2?5 , the total consumption of drugs and the number of
attempts were significantly decreased, and the satisfaction score was significantly increased in group PIEB ( P<0?05) . The height of sensory block in the thoracic vertebra was significantly higher, and the height of sensory block in the lumbosacral spine was significantly lower in group PIEB than in group CEI ( P<0?05) . There were no significant differences between the two groups in the duration of every stage, delivery mode, postpartum hemorrhage volume, incidence of adverse reactions and Apgar scores of neonates (P>0?05). Conclusion PIEB provides reliable efficacy for labor analgesia in parturients, the degree of primiparae′satisfaction is high without increasing the occurrence of adverse reactions, and it exerts no effect on the neonates.
