Application Of Programmed Intermittent Epidural Bolus In Women Labor Analgesia

Objective: To evaluate the safety and effectiveness of programmed intermittent epidural bolus（PIEB）technology and to establish a delivery analgesic administration method suitable for pregnant women in China.Methods: Used cluster sampling method,from March 2019 to February 2020,200 cases of pregnant women who requested labor analgesia in the obstetrics in my hospital were selected as the research object,and all pregnant women were divided into pulse injections pump group（group A）and general injection pump group（group B）accorded to the principle of random number table that 100 pregnant women in each groups.Group A were pulsed injection of 10 ml,2 minutes to complete the injection,an interval of 1 hour,self-controlled medication 5ml,lock time 30 minutes;Group B were given continuous dose of 10 ml / h,self-controlled medication 5ml,lock time 30 minutes.The analgesic pump drugs were 0.08% ropivacaine + 0.4ug/ml sufentanil + normal saline,with a total amount of 120 ml.Recorded the general information of pregnant women,record the pain status and movement block at 1h,2h,4h and 6h of the two groups,record the time of the first,second and third labor of the two groups,and recorded the analgesic medication The total amount,the amount of oxytocin used,the number of patient-controlled epidural analgesic compressions,the time for the first additional medication,and the delivery methods and neonatal 1min Apgar score and5 min Apgar score of the two groups were recorded.Recorded the occurrence of adverse reactions in both groups.Results: The American standards association（ASA）classification,age,gestational age,weight,height,type of pregnant woman,analgesia compared between the two groups were no significant difference（P> 0.05）.There were no significant difference in the visual analogue scale（VAS）score compared between group B and group A pregnant women at 1h,2h after analgesia（P> 0.05）.The VAS scores at 4h and 6h showed statistically significant difference.（P <0.05）.The incidence rates of outbreak pain in group A were significantly lower than that in group B（P <0.05）.Pain outbreak time after analgesia in group A was later than that in group B.All pregnant women of Bromage score were 0 points during analgesia.The first stage of labor in group A were significantly lower than that in group B（P <0.05）,and there were no statistically significant difference in time between the second and third stage of labor compared between the two groups（P> 0.05）.The total amount of analgesic drugs used,the amount of oxytocin used,and the number of patient-controlled epidural analgesic compressions in group A were all significantly shorter than those in group B（P <0.05）.All pregnant women were successfully completed delivery.The proportion of anaesthesia level above T10 in group A was.0%,which was significantly higher than that in group B（P <0.05）.There were no statistically significant difference in the 1min Apgar score and 5min Apgar score compared between the two groups of newborns.There was no significant difference in the incidence of adverse reactions such as hypotension,nausea and pruritus between the two groups during delivery（P > 0.05）.Conclusion: The programmed intermittent epidural bolus technology can reduce the total amount of analgesic drugs,reduce the occurrence of pain and shorten the time of the first stage of labor.so as to benefit mothers and infants.It is a safe and effective way of delivery analgesia administration.