Dural puncture epidural block combined with programmed intermittent epidural boluses for labor analgesia:a randomized controlled study

<b>Objective</b> To investigate the effects of the dural puncture epidural(DPE) block combined with programmed intermittent epidural boluses(PIEB) technique for labor analgesia. <b>Methods</b> A total of 180 primiparas delivered in the Second Affiliated Hospital of Guilin Me...

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Main Authors: LUO Xi-bao, BAI Yan, ZHANG Xu, MI Qiao-qiao, GUAN Fei-jie, SHI Min, LONG Yu-fang
Format: Article
Language:zho
Published: The Editorial Department of Chinese Journal of Clinical Research 2022-12-01
Series:Zhongguo linchuang yanjiu
Subjects:
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author LUO Xi-bao
BAI Yan
ZHANG Xu
MI Qiao-qiao
GUAN Fei-jie
SHI Min
LONG Yu-fang
author_facet LUO Xi-bao
BAI Yan
ZHANG Xu
MI Qiao-qiao
GUAN Fei-jie
SHI Min
LONG Yu-fang
author_sort LUO Xi-bao
collection DOAJ
description <b>Objective</b> To investigate the effects of the dural puncture epidural(DPE) block combined with programmed intermittent epidural boluses(PIEB) technique for labor analgesia. <b>Methods</b> A total of 180 primiparas delivered in the Second Affiliated Hospital of Guilin Medical College from June 2021 to January 2022 were randomly divided into routine epidural block(EPL) combined with PIEB group(EPL group), combined subarachnoid epidural lolock(CSE) with PIEB group(CSE group) and DPE combined with PIEB group(DPE group). After the epidural loading dose was administered, the conventional pulse pump with 0.075% ropivacaine and 0.4 μg/ml sufentanil mixture was respectively placed according to the grouping scheme. In EPL group and DPE group, the analgesia pump was turned on 1 hour after giving loading dose, and the pulse dose was 10 ml each time at a 1-hour interval. In CSE group, the analgesic pump was turned on 1 hour after subarachnoid injection, and the pulse dose was 10ml each time for epidural administration at a 1-hour interval. Visual analog scores(VAS) during uterine contraction were measured before labor analgesia(T0), 10 min(T1)-, 20 min(T2)-, 30 min(T3)-, 60 min(T4)-, 120 min(T5)-after epidural administration, at the full time of the uterine opening(T6) and at the time of fetal delivery(T7). The onset time of effective analgesia, the incidence of breakthrough pain(BTP) and adverse reactions during labor were recorded and compared among three groups. <b>Results</b> There were 59 cases in EPL group, 60 cases in CSE group and 59 cases in DPE group. The onset time of effective analgesia in DPE group and CSE group was significantly faster than that in EPL group, while that in CSE group was significantly faster than that in DPE group(<i>P</i><0.017). Compared with EPL group, the rates of patient-controlled combined spinal epidural analgesia (PCEA), requiring rescue analgesia and incomplete sacrococcygeal block, and the hourly consumption of ropivacaine in CSE group and DPE group decreased significantly(<i>P</i><0.017). At T1, VAS scores in DPE group and CSE group were significantly lower than that in EPL group(<i>P</i><0.05), and in DPE group was statistically higher than that in CSE group(<i>P</i><0.05). At T2, VAS score in CSE group was significantly lower than that in EPL group(<i>P</i><0.05), and the incidence of pruritus in EPL group and DPE group was significantly lower than that in CSE group(<i>P</i><0.017). <b>Conclusion</b> DPE combined with PIEB technology has a faster analgesic effect and a lower incidence of BTP compared with traditional EPL technology and can be safely and effectively used for labor analgesia.
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spelling doaj.art-d824051062f14dcfaabd3121a3951f4c2023-01-04T08:25:28ZzhoThe Editorial Department of Chinese Journal of Clinical ResearchZhongguo linchuang yanjiu1674-81822022-12-0135121647165210.13429/j.cnki.cjcr.2022.12.003Dural puncture epidural block combined with programmed intermittent epidural boluses for labor analgesia:a randomized controlled studyLUO Xi-bao0BAI Yan1ZHANG Xu2MI Qiao-qiao3GUAN Fei-jie4SHI Min5LONG Yu-fang6Department of Anesthesiology,The Second Affiliated Hospital of Guilin Medical UniversityDepartment of Anesthesiology,The Second Affiliated Hospital of Guilin Medical UniversityDepartment of Anesthesiology,The Second Affiliated Hospital of Guilin Medical UniversityDepartment of Anesthesiology,The Second Affiliated Hospital of Guilin Medical UniversityDepartment of Anesthesiology,The Second Affiliated Hospital of Guilin Medical UniversityDepartment of Anesthesiology,The Second Affiliated Hospital of Guilin Medical UniversityDepartment of Anesthesiology,The Second Affiliated Hospital of Guilin Medical University<b>Objective</b> To investigate the effects of the dural puncture epidural(DPE) block combined with programmed intermittent epidural boluses(PIEB) technique for labor analgesia. <b>Methods</b> A total of 180 primiparas delivered in the Second Affiliated Hospital of Guilin Medical College from June 2021 to January 2022 were randomly divided into routine epidural block(EPL) combined with PIEB group(EPL group), combined subarachnoid epidural lolock(CSE) with PIEB group(CSE group) and DPE combined with PIEB group(DPE group). After the epidural loading dose was administered, the conventional pulse pump with 0.075% ropivacaine and 0.4 μg/ml sufentanil mixture was respectively placed according to the grouping scheme. In EPL group and DPE group, the analgesia pump was turned on 1 hour after giving loading dose, and the pulse dose was 10 ml each time at a 1-hour interval. In CSE group, the analgesic pump was turned on 1 hour after subarachnoid injection, and the pulse dose was 10ml each time for epidural administration at a 1-hour interval. Visual analog scores(VAS) during uterine contraction were measured before labor analgesia(T0), 10 min(T1)-, 20 min(T2)-, 30 min(T3)-, 60 min(T4)-, 120 min(T5)-after epidural administration, at the full time of the uterine opening(T6) and at the time of fetal delivery(T7). The onset time of effective analgesia, the incidence of breakthrough pain(BTP) and adverse reactions during labor were recorded and compared among three groups. <b>Results</b> There were 59 cases in EPL group, 60 cases in CSE group and 59 cases in DPE group. The onset time of effective analgesia in DPE group and CSE group was significantly faster than that in EPL group, while that in CSE group was significantly faster than that in DPE group(<i>P</i><0.017). Compared with EPL group, the rates of patient-controlled combined spinal epidural analgesia (PCEA), requiring rescue analgesia and incomplete sacrococcygeal block, and the hourly consumption of ropivacaine in CSE group and DPE group decreased significantly(<i>P</i><0.017). At T1, VAS scores in DPE group and CSE group were significantly lower than that in EPL group(<i>P</i><0.05), and in DPE group was statistically higher than that in CSE group(<i>P</i><0.05). At T2, VAS score in CSE group was significantly lower than that in EPL group(<i>P</i><0.05), and the incidence of pruritus in EPL group and DPE group was significantly lower than that in CSE group(<i>P</i><0.017). <b>Conclusion</b> DPE combined with PIEB technology has a faster analgesic effect and a lower incidence of BTP compared with traditional EPL technology and can be safely and effectively used for labor analgesia. dural puncture epidural blockepidural blockcombined subarachnoid epidural blockprogrammed intermittent epidural bolus techniquelabor analgesia
spellingShingle LUO Xi-bao
BAI Yan
ZHANG Xu
MI Qiao-qiao
GUAN Fei-jie
SHI Min
LONG Yu-fang
Dural puncture epidural block combined with programmed intermittent epidural boluses for labor analgesia:a randomized controlled study
Zhongguo linchuang yanjiu
dural puncture epidural block
epidural block
combined subarachnoid epidural block
programmed intermittent epidural bolus technique
labor analgesia
title Dural puncture epidural block combined with programmed intermittent epidural boluses for labor analgesia:a randomized controlled study
title_full Dural puncture epidural block combined with programmed intermittent epidural boluses for labor analgesia:a randomized controlled study
title_fullStr Dural puncture epidural block combined with programmed intermittent epidural boluses for labor analgesia:a randomized controlled study
title_full_unstemmed Dural puncture epidural block combined with programmed intermittent epidural boluses for labor analgesia:a randomized controlled study
title_short Dural puncture epidural block combined with programmed intermittent epidural boluses for labor analgesia:a randomized controlled study
title_sort dural puncture epidural block combined with programmed intermittent epidural boluses for labor analgesia a randomized controlled study
topic dural puncture epidural block
epidural block
combined subarachnoid epidural block
programmed intermittent epidural bolus technique
labor analgesia
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