程控间断硬膜外给药复合自控镇痛联合导乐分娩镇痛仪在初产妇分娩中的应用

目的 评价程控间断硬膜外给药(PIEB)复合自控镇痛(PCA)联合导乐分娩镇痛仪在初产妇分娩中的应用效果.方法 选取2018年9月至2020年11月在医院行阴道自然分娩并要求分娩镇痛的280名初产妇,按照纳入项目顺序编号,采用自愿结合数字表法随机将其分为PG1、PG2、P、G共4组,每组70名.PG1组(0.05％罗哌...

Application of the Programmed Intermittent Epidural Bolus Technique Added to Patient Controlled Analgesia Regimen in Conjunction with Doula Labor Analgesia Instrument in Primipara Delivery

Objective The application effects of the programmed intermittent epidural bolus(PIEB)technique added to patient controlled analgesia(PCA)regimen in conjunction with doula labor analgesia instrument in primipara delivery were investigated.Methods 280 full term nulliparous parturients who underwent vaginal delivery in the hospital from September 2018 to November 2020 and required labour analgesia were randomly divided into group PG1,PG2,P and G through volunteering combined with number table method according to the sequence of being included in this study.Each group had 70 subjects.Group PG1(0.05%ropivacaine with 0.5μg/ml sufentanil citrate)and group PG2(0.075%ropivacaine with 0.5μg/ml sufentanil citrate)delivered with PIEB combined with PCA and doula labor analgesia instrument.Group P(0.075%ropivacaine with 0.5μg/ml sufentanil citrate)delivered with PIEB combined with PCA.Group G delivered with doula labor analgesia instrument.The visual analogue scale(VAS)scores of the four groups were compared in different stages including immediately prior to labor analgesia(T₀),then hourly after anesthesia for five hours(T₁,T₂,T₃,T₄,T₅),when cervix fully open(T₆),and one hour after delivery(T₇).Besides,the delivery status and maternal satisfaction were also compared.Results The VAS scores of group PG1,PG2 and P were all lower than those of group G at T₃,T₄,T₅,T₆ and T₇,with statistically significant differences(P<0.05);The VAS scores of group PG1 and PG2 were both lower than that of group P at T₆,with statistically significant differences(P<0.05).The incidence of intrapartum fever in group PG1 and G were both lower than those in group PG2 and P,with statistically significant differences(P<0.05).The natural delivery rate and maternal satisfaction of group PG1,PG2 and P were higher than those in group G,and group PG1 was higher than group P,with statistically significant differences(P<0.05).The pressing frequency of PCA in group PG1 and group PG2 were less than that in group P,and the anesthetic consumption of group PG1 was less than that of group P,with statistically significant differences(P<0.05).Conclusion The application effects of the PIEB technique added to PCA regimen in conjunction with doula labor analgesia instrument for labor analgesia were obvious,which can relieve labor pain,decrease the total anesthetic consumption and the pressing frequency of PCA,improve the natural delivery rate and maternal satisfaction,and meanwhile decrease the risks of intrapartum fever by reducing the concentration of epidural local anesthesia.