Comparison Of The Effects Of Transcutaneous Electrical Acupoint Stimulation And Percutaneous Lumbosacral Nerve Electrical Stimulation In Labor Analgesia

Objective:To observe the effects of transcutaneous electrical acupoint stimulator（TEAS）and transcutaneous electrical nerve stimulator（TENS）in labor analgesia.Methods:A total of 186 eligible primiparas were selected as the research objects,6 cases were excluded,and they were randomly divided into three groups:TEAS group,TENS group and patient controlled epidural analgesia（PCEA）group,with 60 cases in each group.The TEAS group received transcutaneous electrical acupoint stimulation for analgesia,and the acupoints were selected from bilateral Hegu and Sanyinjiao;The TENS group received transcutaneous electrical nerve stimulation for analgesia,and the bilateral spinal nerve roots of T₁₀-L₁and S₂-S₄segments were selected,and the stimulation current intensity of the two groups was 15 m A-50m A,alternate stimulation with 2Hz/100Hz sparse and dense waves at intervals of 3 seconds;In the PCEA group,patient-controlled epidural anesthesia was used for analgesia.The internal cervical opening is 3 cm larger and the pain relief begins until the fetus is delivered from the mother.The visual analogue scale（VAS）of pain immediately before analgesia,30 minutes,60 minutes,and 120 minutes after analgesia was recorded;The levels ofβ-endorphins in blood immediately before analgesia and 120 minutes after analgesia were detected respectively;Apgar score at 1 and 5minutes after birth,umbilical artery blood gas analysis index of newborns,length of active stage and second stage of labor,oxytocin use rate and incidence of adverse reactions,amount of postpartum hemorrhage at 2 hours and maternal satisfaction with analgesia were recorded.Results:There was no significant difference in the VAS score between the groups immediately before analgesia（P>0.05）;There were significant differences between the three groups of puerperae after analgesia and immediately before analgesia（P<0.05）;The VAS score 30 minutes after analgesia was significantly different between the TEAS group and the TENS group and the PCEA group（P<0.01）,but there was no significant difference between the TEAS group and the TENS group（P>0.05）.The 60-minute and120-minute VAS scores were significantly different between the TEAS group and the TENS group and the PCEA group（P<0.01）.The VAS score in the TEAS group was higher than that in the TENS group（P<0.05）.Before analgesia,there was no significant difference in the content ofβ-endorphin among the groups（P>0.05）.At 120 minutes after analgesia,the TEAS group and the TENS group increased,while the PCEA group decreased.There was no difference between the TEAS group and the TENS group（P>0.05）,TEAS group and TENS group were compared with PCEA group,the difference was statistically significant（P<0.05）.The active stage of the first stage of labor and the duration of the second stage of labor in the TEAS group and the TENS group were shorter than those in the PCEA group（P<0.05）.There was no significant difference between TEAS group and TENS group（P>0.05）.The use rate of oxytocin and the incidence of adverse reactions in the TEAS group and the TENS group were lower than those in the PCEA group（P<0.05）,and there was no significant difference between the TEAS group and the TENS group（P>0.05）.There were no significant differences in Apgar scores and umbilical artery blood gas analysis indexes between the groups at 1 minute and 5 minutes after birth（P>0.05）.The amount of postpartum hemorrhage at 2 hours in TEAS group and TENS group was less than that in PCEA group（P<0.05）,and there was no significant difference between the TEAS group and the TENS group（P>0.05）.Maternal analgesic effect satisfaction in PCEA group was higher than that in TEAS group and TENS group（P<0.05）,which was also reflected in whether to continue to choose the same analgesic method next time（P<0.05）.Conclusion:TEAS and TENS can relieve labor pain,and the analgesic effect of TENS is better than TEAS;The duration of the first stage of labor and the second stage of labor when TEAS and TENS are applied to labor analgesia is shorter than that of PCEA,and the use rate of oxytocin is not increased,the incidence of adverse reactions is low,and there is no effect on newborns.The amount of postpartum hemorrhage of parturients is less than that of PCEA,non-invasive,without any drugs and easy to operate;However,when TEAS and TENS are applied to labor analgesia alone,the analgesic effect is not ideal.This disadvantage limits their wide use in labor analgesia.They can be used as auxiliary labor analgesia in units that do not carry out intraspinal labor analgesia or patients with intraspinal anesthesia contraindications.