Application of epidural block technique combined with program-controlled epidural intermittent pulse infusion in labor analgesia
Objective:To observe the clinical application and safety of dural punctwre epidwral block fechnique(DPE)combined with program-controlled epidural intermittent pulse injection(PIEB)in labor analgesia.Methods:120 cases of parturient with single head position were randomly divided into epidural block group(EP group)and epidural block group(DPE group)(n=60).The L2-L3 space was selected as the intraspinal puncture point.In the EP group,epidural patient-controlled analgesia(PCEA)was initiated after successful puncture,and the continuous infusion dose was 10 mL/h.In the DPE group,after the epidural puncture was successful,the dural membrane was broken with lumbar acupuncture,and the injection liquid was not pushed into the subarachnoid space,the lumbar acupuncture needle was withdrawn,and a cephalic tube was placed to connect the pulse automatic injection pump with a continuous dose of 5 mL/h,and then automatic pulse injection of 5mL every 1 hour.The analgesic pump anesthetic liquid in both groups was 0.08％ropivacaine hydrochloride+0.4ug/mL sufentanil,and the first dose was 8 mL,the self-controlled analgesic dose was 5 mL,and the locking time was 30 min.Visual analogue scores(VAS)were compared before analgesia(T0),30min after analgesia(T1),1h(T2)and during delivery(T3).The effective time of analgesia,labor course,patient controlled analgesia(PCA)compress times and total narcotic dosage were recorded in the two groups.Adverse reactions such as headache,respiratory depression,hypotension were recorded in both groups,as well as Apgar scores at 1min of neonates.Results:There was no significant difference in VAS scores at T0,T1 and T2 time between the two groups(P＞0.05).At T3 time VAS score of DPE group was lower than that of PE group,and the difference was statistically significant(P＜0.05).There were no significant differences in total labor duration,Apgar score of 1min between the two groups,and the incidence of adverse reactions(P＞0.05).The analgesic onset time in DPE group was faster,The PC A compress times and the total amount of analgesic liquid was lower than those in PE group,the difference was statistically significant(P＜0.05).Conclusion:DPE combined with PIEP technique for labor analgesia has better analgesic effect,short onset time,less total drug,and obvious advantages.
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