Application effect and safety comparison of intermittent epidural bolus and continuous epidural infusion combined with patient-controlled epidural analgesia in labor analgesia
ZHANG Hongzhi YE Chunfang HUANG Wenxin
Department of Anesthesiology, Huangshan City People’s Hospital, Anhui Province, Huangshan 245000, China
Abstract：Objective To study the application effect and safety of intermittent epidural bolus (IEB) and continuous epidural infusion (CEI) combined with patient-controlled epidural analgesia (PCEA) in labor analgesia. Methods From January to July 2020, 80 full-term primiparas who voluntarily accepted epidural labor analgesia were selected as the research objects. According to the random number table method, they were divided into study group (40 cases) and control group (40 cases). Control group was treated with CEI combined with PCEA, and study group was treated with IEB combined with PCEA. The first, second, third stage of labor, blood loss, cesarean section rate were compared between two groups; visual analogue scale (VAS) score of pain before analgesia, 10, 30, 60 min after analgesia, and when the uterine orifice was fully opened were compared between two groups; the time of the first PCEA, PCEA usage rate and analgesic dosage, the time of the first burst of pain, the size of uterine orifice at the time of the first burst of pain, the incidence rate of burst pain, the total satisfaction degree and the total incidence of complications were compared between two groups. Results There were no significant differences in the first, second, third stage of labor, blood loss, and cesarean section rate between two groups (P > 0.05). VAS scores of two groups were lower than those before analgesia on 10, 30, 60 min after analgesia, and when the uterine orifice was fully opened (all P < 0.05); while there were no significant differences in VAS scores between two groups at each time point (P > 0.05). There were no significant differences in the time of the first PCEA and PCEA usage rate between two groups (P > 0.05); while the analgesic dosage in study group was lower than that in control group (P < 0.05). The time of the first burst of pain in study group was longer than that in control group, and the size of uterine orifice at the time of the first burst of pain was larger than that in control group, and the incidence rate of burst pain was lower than that in control group (all P < 0.05). The total satisfaction of study group was higher than that of control group (P < 0.05). There was no significant difference in the total incidence of complications between two groups (P > 0.05). Conclusion In epidural labor analgesia, IEB has better effect, can effectively reduce the incidence of burst pain, safe and reliable, and has clinical application value.
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