Clinical efficacy of programmed intermittent epidural bolus and continuous epidural infusion for labor analgesia / 临床麻醉学杂志

ABSTRACT

Objective To compare the clinical efficacy of programmed intermittent epidural bollus (PIEB)+patient controlled epidural analgesia (PCEA)and continuous epidural infusion (CEI)+PCEA for labor analgesia.Methods One hundred nulliparous parturients with cervical dilation of 2-3 cm were randomly assigned to PIEB group or CEI group for labor,with 100 parturients in each group.The background infusion in PIEB group delivered 8 ml bolus at a rate of 6 ml/min per 1 hour, in group CEI at 8 ml/h.Blood pressure,VAS score and modified Bromage score before labor anesthe-sia (T0 ),10 min after labor anesthesia (T1 ),30 min after labor anesthesia (T2 ),1 h after labor an-esthesia (T3 ),2 h after labor anesthesia (T4 ),the uterus opening to the full extent (T5 ),childbirth (T6 ),1 h after childbirth (T7 ),proportion of PCEA request,hourly ropivacaine and sufentanil con-sumption,uterine contraction,fetal heart,total delivery time,analgesic time,delivery mode,number of cases using oxytocin,adverse reactions,neonatal Apgar score,maternal satisfaction score were ob-served.Results The VAS score of PIEB group was significantly lower than that of CEI group at T4-T6 (P <0.01).Compared with the CEI group,protortion of PCEA request,the dosage of drug was de-creased obviously in group PIEB (P <0.05),the maternal satisfaction of PIEB group was significantly higher than that of CEI group (P <0.05).There was no significant difference in the blood pressure, duration and interval time of uterine contraction,fetal heart,total delivery time,analgesic time,deliv-ery mode,number of cases using oxytocin,adverse reactions,neonatal Apgar score and weight among two groups.Conclusion Compared with the CEI+PCEA,the need of PCEA and the dosage of drug was decreased obviously,the VAS score was significantly lower,the maternal satisfaction was signifi-cantly higher and adverse reactions did not increase in the PIEB+PCEA.