Effects of dural puncture epidural block on the dosage of Ropivacaine, stress response, and pregnancy outcome in painless delivery
JIANG Yueming1 ZHU Jinming2 PENG Chong1 LI Weiwei1 SHEN Wen3▲
1.Department of Anesthesiology, Xuzhou Maternal and Child Health Hospital Affiliated to Xuzhou Medical University, Jiangsu Province, Xuzhou 221010, China; 2.Department of Obstetrics, Xuzhou Maternal and Child Health Hospital Affiliated to Xuzhou Medical University, Jiangsu Province, Xuzhou 221010, China; 3.Department of Pain Treatment, Xuzhou Maternal and Child Health Hospital Affiliated to Xuzhou Medical University, Jiangsu Province, Xuzhou 221002, China
Abstract：Objective To investigate the effects of dural puncture epidural block on the dosage of Ropivacaine, stress response, and pregnancy outcome in painless delivery. Methods A total of 204 pregnant women who underwent painless delivery in Xuzhou Maternal and Child Health Hospital Affiliated to Xuzhou Medical University from May to December 2021 were selected as the research objects. They were divided into dural puncture group (dural puncture epidural block) and control group (routine epidural block), with 102 pregnant women in each group. The levels of blood glucose, serum cortisol, and norepinephrine in two groups were measured before analgesia and 30 min analgesia were compared; and the visual analogue scale (VAS) score in two groups before analgesia, 30 min analgesia, 60 min analgesia and delivery were compared; the onset time of analgesia, the consumption of Ropivacaine, the first patient controlled analgesia (PCA) time in two groups were compared; the occurrence of adverse reactions was recorded of pregnant women in two groups; the Apgar scores 1 and 5 min after birth and the occurrence of adverse reactions were compared between two groups. Results The levels of blood glucose, cortisol, and norepinephrine 30 min analgesia in two groups were higher than those before analgesia, and the differences were statistically significant (P＜0.05); the levels of blood glucose, cortisol, and norepinephrine in dural puncture group were lower than those in control group, and the differences were statistically significant (P＜0.05). There was statistical significance between two groups at different time points (P＜0.05). The VAS scores of dural puncture group were lower than those of control group at 30 min analgesia, 60 min analgesia and delivery, and the differences were statistically significant (P＜0.05). The dosage of Ropivacaine in dural puncture group was lower than that in control group, the onset time of analgesia was shorter than that in control group, and the duration of first PCA was longer than that in control group, and the differences were statistically significant (P＜0.05). There was no significant difference in the incidence of adverse reactions between two groups (P＞0.05). There were no significant differences in Apgar scores 1 and 5 min between two groups (P＞0.05). There were no adverse outcomes such as respiratory depression and nerve injury in two groups. Conclusion Dural puncture epidural block has quick effect, reduces stress response of pregnant women, and can reduce the dosage of Ropivacaine, which has no adverse effect on maternal and neonatal outcomes.
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