Effect of epidural puncture combined with dual epidural block on labor analgesia and on maternal blood pressure and fetal umbilical arteriovenous blood gas in pregnancy-induced hypertension
10.3760/cma.j.cn115455-20240319-00252
- VernacularTitle:硬脊膜穿破硬膜外联合双管硬膜外阻滞对妊娠期高血压产妇分娩镇痛的效果及对产妇血压、胎儿脐动静脉血气的影响
- Author:
Jiaying XIN
1
;
Xuebo BAI
1
;
Zhaoguo LI
1
Author Information
1. 济宁医学院附属医院麻醉科，济宁 272007
- Publication Type:Journal Article
- Keywords:
Hypertension, pregnancy-induced;
Analgesia, obstetrical;
Epidural puncture block;
Double tube epidural block
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(4):373-378
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of dural puncture epidural (DPE) combined with dual tube epidural block in labor analgesia of hypertensive women with pregnancy and its impact on fetal umbilical arteriovenous blood gas.Methods:A total of 120 pregnant women with gestational hypertension who underwent vaginal delivery from February to August 2023 in the Affiliated Hospital of Jining Medical College were prospectively selected and divided into two groups by random number table method, with 60 cases in each group. The observation group was given DPE combined with double epidural block for analgesia, and the control group was given double epidural block for analgesia. Blood pressure level, Digital Pain Rating Scale (NRS) score, analgesia quality and efficiency, anesthesia level, adverse reactions and fetal umbilical arteriovenous blood gas analysis were compared between the two groups before and after injection.Results:The systolic blood pressure and diastolic blood pressure in the two groups were significantly decreased at 15 min, 30 min, 1 h and 2 h after injection, and the systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group at the above time points, there were statistical differences ( P<0.05). The NRS scores at 30 min, 1 h and 2 h after injection in the observation group were lower than those in the control group: (3.30 ± 0.25) scores vs. (4.91 ± 0.28) scores, (2.18 ± 0.37) scores vs. (3.25 ± 0.43) scores, (1.76 ± 0.21) scores vs. (2.44 ± 0.22) scores, there were statistical differences ( P<0.05). The time required for T 10 to reach the anesthetic plane in the observation group was shorter than that in the control group: (9.10 ± 1.35) min vs. (13.25 ± 1.64) min, there was statistical difference ( P<0.05). The dosage of analgesic drugs (sufentanil), the proportion of the highest sensory anesthesia plane to T 6, and the proportion of the lowest sensory anesthesia plane to S 4 between the two groups had no statistical differences ( P>0.05). The onset time of analgesia in the observation group was shorter than that in the control group: (12.34 ± 3.45) min vs. (17.13 ± 3.57) min, and the number of relief analgesia was lower than that in the control group: (1.74 ± 0.32) times vs. (2.09 ± 0.45) times, there were statistical differences ( P<0.05). The incidence of adverse reactions between the two groups had no statistical differences ( P>0.05). The pH value, partial pressure of arterial oxygen, partial pressure of arterial carbon dioxide and residual alkali between the two groups had no statistical differences ( P>0.05). Conclusions:DPE combined with double tube epidural block has a significant effect on labor analgesia in pregnant women with hypertension, which can effectively improve the efficiency and quality of analgesia, relieve maternal pain. In addition, the combined therapy has little impact on the stablity of blood pressure, and fetal umbilical arteriovenous blood gas, which hardly generate adverse events and deserved for clinical promotion.
