不同时间间隔程控硬膜外间歇脉冲式注射(PIEB)用于分娩镇痛的临床观察

目的 探讨用于分娩镇痛的程控硬膜外间歇脉冲式注射(PIEB)技术的注药时间间隔.方法 选取2018年5月至2019年8月在本院拟阴道分娩并接受椎管内镇痛的产妇342例,随机分为A组(n=112)、B组(n=116)和C组(n=114),分别于首剂药物注射后40 min、60 min和80 min启动PIEB.按开始实施...

Clinical observation of different time interval programmed epidural intermittent pulse injection (PIEB) for labor analgesia

Objective To explore the injection interval of programmed intermittent epidural bolus(PIEB)for labor analgesia.Methods 342 parturients who had undergone intravertebral analgesia in labor from May 2018 to August 2019 were randomly divided into three groups:group A(n=112),group B(n=116)and group C(n=114),and PIB was activated 40 min,60 min and 80 min after the initial injection,respectively.According to the seven time points:start of labor analgesia(T₁),10 min(T₂),60 min(T₃),80 min(T₄)and 120 min(T₅)after first epidural injection,full opening of uterine orifice(T₆),and 1 h after delivery(T₇),the data were recorded to statistically analyze the pain degree and satisfaction at different time points,as well as effective PCA frequency,Apgar score of neonate 1 min and 5 min after birth,motor block and adverse reaction for the three groups of parturients.Results VAS scores of group A at T₃,T₄,T₅and T₆were significantly lower than those in group B and group C,and VAS scores of group C were significantly higher than those in group A and group B(P<0.05).The analgesia satisfaction in group A was significantly higher than that in group B and group C(P<0.05).The effective frequency of PCA in group A and group B was evidently less than that in group C(P<0.05).There was no statistical significance of difference on Apgar scores,motor block and adverse reaction at 1 min and 5 min after birth.Conclusion PIEB has accurate and reliable effects on labor analgesia with anesthetic drug at an interval of 40 minutes is reliable,with slight impact on motor nerve,less adverse reaction and less influence on newborns,it is an ideal method for setting PIEB injection for analgesia in labor.