Effect of programmed intermittent epidural bolus at different interval time for labor analgesia
[Objective]To compare the clinical efficacy of programmed intermittent epidural bolus (PIEB) with continuous epidural infusion (CEI) at different interval time for labor analgesia.[Methods]A total of 229 primiparous full-term singleton pregnant women requiring labor analgesia were randomly divided into three groups:PIEB mode at an interval of 30 min group (group P30,n=77),PIEB mode at an interval of 60 min group (group P60,n=76) and traditional CEI mode group (group C,n=76).Epidural catheters was placed at the L3-4 interspace with the subject in lateral position.Epidural solution was 0.08％ ropivacaine and 0.3 μg/mL sufentanil,and the initial loading dose was 10 mL.PIEB regimens were programmed as bolus 5 mL per 30 min starting from 30 min after analgesia began in group P30 and bolus 10 mL per 60 min starting from 60 min after analgesia began in group P60.Group C received continuous infusion at 10 mL/h immediately when analgesia began.The patient-controlled epidural analgesia (PCEA) dose was 5 mL with a 10 minutes lockout.The drugs used in the pump were 0.08％ ropivacaine and 0.3 μg/mL sufentanil in three groups.Visual Analog Scale (VAS) scores and modified Bromage scores were recorded before labor analgesia,1,2,3 and 4 hours after labor analgesia,at full dilation of the cervix and during delivery.The consumption of anesthetic,the number of pressing of self-controlled analgesia pump,and occurrence of adverse reactions were recorded.[Results]The VAS scores obviously decreased in the three groups since receiving labor analgesia (P<0.05).Compared with group C,the VAS scores of group P30 and group P60 were decreased 3 and 4 hours after labor analgesia,at full dilation of the cervix and during delivery (P<0.05).The VAS scores of group P60 at the uterus fully opened and delivery were lower than those in group P30 (P<0.05).The total drug consumption and the number of PCEA were decreased obviously in group P30 and group P60 (P<0.05).The effective frequency of PCEA in group P60 was less than that in group P30 (P<0.05).The analgesia satisfaction in group P60 was higher than that in group P30 and group C (P<0.05).There were no significant differences in the duration of labor,Bromage score,occurrence of adverse reactions among the three groups.[Conclusion]PIEB provides reliable efficacy for labor analgesia and PIEB injection at an interval time of 60 min is an ideal method.
万方数据
维普
