The Application Effect of Dural Puncture Epidural Block Combined with Programmed Intermittent Epidural Bolus Mode in Pain Alleviation during Multipara Delivery
Objective:To evaluate the effect of dural puncture epidural(DPE)block combined with programmed intermittent epidural bolus(PIEB)mode in multipara labor analgesia and its effect on neonates.Method:A total of 180 multipara aged 37-42 weeks,single fetal head position,and classified as class Ⅰ or Ⅱ by the American society of anesthesiologists(ASA)from March to April 2023 at Jiangxi Maternal and Child Health Hospital were selected to undergo intraspinal delivery analgesia.Using an online random number generator,postpartum women were divided into three groups:the DPE block combined with PIEB mode group(DPE+PIEB group,60 cases),the DPE block combined with continuous epidural infusion(CEI)mode group(DPE+CEI group,60 cases),and the simple epidural(EP)block combined with CEI mode group(EP+CEI group,60 cases).The duration of achieving"satisfactory analgesia"within 30 minutes,the incidence of manual medication administration without satisfactory analgesia after 30 minutes,the analgesic effect and blocking situation,adverse reactions,and fetal delivery among three groups of postpartum women were compared.Result:Satisfactory anesthesia was achieved faster in the DPE+CEI group and DPE+PIEB group than that in the EP+CEI group(P<0.05).The total consumption of Ropivacaine in the three groups was:DPE+PIEB group<DPE+CEI group<EP+CEI group(P<0.05).The upper limit of the block plane was T10 in three groups.The Bromage score of all three groups was 0;there were no significant differences in the total duration of labor,maternal catheter replacement rate,pruritus,headache,nerve injury,and fetal bradycardia among the three groups(P>0.05).The incidence of Apgar score≤7 scores at 1 min and 5 min after birth in all three maternal newborn groups was 0.Conclusion:DPE block combined with PIEB mode for multipara labor analgesia can significantly shorten the onset time of medication,enhance the analgesic effect,reduce the amount of Ropivacaine,does not affect the progress of labor and has no adverse effects on newborns.
万方数据
维普
