Journal of Jilin University(Medicine Edition) ›› 2021, Vol. 47 ›› Issue (5): 1258-1263.doi: 10.13481/j.1671-587X.20210525

• Research in clinical medicine • Previous Articles     Next Articles

Application of programmed intermittent epidural bolus mode in labor analgesia and its effect on umbilical cord blood flow and blood gas in umbilical arteryPAN Xuelin1,LIU Qing2,ZHANG Ying2,TANG Yong1(1.Department of Anesthesiology, Sichuan Jinxin Women and Children’s Hospital,Chengdu 610011,China;2.Department of Anesthesiology, Affiliated Hospital of Traditional Chinese Medicine, Southwestern Medical University,Luzhou 646000,China)

  

  • Received:2020-12-10 Online:2021-09-28 Published:2021-10-26

Abstract: Objective

To explore the effect of programmed intermittent epidural bolus(PIEB) mode for labor analgesia and its influence in the umbilical blood flow and umbilical artery blood gas, and to provide the basis for finding a more ideal mode of epidural labor analgesia.

Methods

Ninety cases of full-term singleton neonates who required labor analgesia were randomly divided into PIEB group and continuous epidural infusion (CEI) group by random number table method,with 45 cases in each group.The maternity patients in two groups were given the first dose (0.08 g·L-1 ropivacaine+0.4 mg·L-1 dexmedetomidine) 10 mL.The maternity patients in PIEB group were connected to the PIEB analgesia pump 1 h after the injection of the first dose, with the pulse dose of 8 mL·h-1 and the speed of 7 mL·min-1;the patients in CEI group were connected to the CEI analgesia pump immediately after the first dose injection, and the continuous background dose was 8 mL·h-1.The VAS pain scores of the maternity patients in two groups before analgesia (T0), 30 min after analgesia (T1),1 h after analgesia (T2), 2 h after analgesia (T3) and full-time uterine opening (T4) were compared. The umbilical artery pulsatitly index (PI), umbilical artery resistance index (RI) and the ratios of systolic peak to diastolic peak (S/D) of fetal umbilical artery blood flow velocity of the patients at T0-T3 were compared. The umbilical artery blood gas pH values, residual alkali (BE) values and the newborn Apgar scores immediately after delivery of the maternity patients in two group were compared.The first stage of labor, the second stage of labor, satisfaction and adverse reactions were compared between two groups.

Results

There were no differences in the VAS scores of the patients at T0, T1, T2 and T3 between two groups (P>0.05).The VAS score of the maternity patients in PIEB group at the T4 time point was lower than that in CEI group (P<0.05). There were no differences in the fetal PI, RI, and S/D ratios of the maternity patients at different time points between two groups (P>0.05).There were no statistically significant differences in the umbilical artery blood gas pH values and BE values of the maternity patients between two groups(P>0.05), and there was no significant difference in the Apgar score between two groups (P>0.05). There were no significant differences in the first stage of labor, the second stage of labor and the adverse reactions between two groups(P>0.05). The score of satisfaction with analgesia of the maternity patients in PIEB group was significantly higher than that in CEI group(P<0.05).

Conclusion

PIEB mode for labor analgesia has no significant effect on the umbilical blood flow and umbilical artery blood gas, and has better safety.

Key words: programmed intermittent epidural bolus, continuous epidural infusion, labor analgesia, umbilical artery flow, umbilical artery blood gas analysis

CLC Number: 

  • R614.4