The Effect Of Transcutaneous Electrical Acupoint Stimulation In Labor Analgesia

Objective:To explore the effect of transcutaneous electrical acupoint stimulation(TEAS)in labor analgesia.Methods:A total of 229 parturients with singleton head position in Rizhao People's Hospital from January 2019 to January 2020 were selected.The subjects were randomly divided into three groups: transcutaneous electrical acupoint stimulation(TEAS)group(n = 76),epidural block anesthesia group(patient-controlled epidural analgesia,PCEA)(n = 75)and control group(n = 78).Transcutaneous electrical acupoint stimulation was used in the TEAS group(the current intensity was 15?50mA,and the frequency of 2Hz/100 Hz wave was alternated every 3 seconds).The acupoints Hegu,Neiguan,Jiaji and Ciliao were selected,epidural anesthesia was used in the PCEA group,and the analgesia time was from the cervical dilation 3cm to the complete dilation of the cervix.The pain visual analogue(Visual analogue scale,VAS)score was recorded immediately before analgesia,30 min,60min and 120 min after analgesia to evaluate the analgesic effect,at the same time,detect plasma?-endorphin;the utilization rate of oxytocin,the incidence of maternal adverse reactions,the rate of conversion to cesarean section,the duration of each stage of labor,postpartum hemorrhage,neonatal 1-minute and 5-minute Apgar score,were secondary objectives,in order to evaluate the effect of transcutaneous electrical acupoint stimulation in labor analgesia.Results:1.After the implementation of analgesia,the VAS score of the transcutaneous electrical acupoint stimulation group and the patient-controlled epidural analgesia group showed a downward trend compared with the control group,and the difference was statistically significant(P < 0.01,P < 0.01),but the decrease of the patient-controlled epidural analgesia group was significantly higher than that of the transcutaneous electrical acupoint stimulation group(P < 0.01).2.The content of plasma ?-endorphin in 120 min after analgesia increased in the transcutaneous electrical acupoint stimulation group and decreased in the patient-controlled epidural analgesia group in three groups.According to the difference of ?-endorphin content 120 min after analgesia and the difference of?-endorphin content immediately before analgesia,there were significant differences between the transcutaneous electrical acupoint stimulation group,the patient-controlled epidural analgesia group and the control group(P < 0.01,P < 0.01),there was significant difference between the patient-controlled epidural analgesia group and the control group(P < 0.01).3.The duration of the first stage of labor in the transcutaneous electrical acupoint stimulation group and the control group was significantly shorter than that in the patient-controlled epidural analgesia group(P < 0.01,P < 0.01),there was no difference in the duration of the first stage of labor between the transcutaneous electrical acupoint stimulation group and the control group(P > 0.05).The duration of the second stage of labor in the transcutaneous electrical acupoint stimulation group was significantly shorter than that in the patient-controlled epidural analgesia group(P < 0.01),and the duration of the second stage of labor in the transcutaneous electrical acupoint stimulation group was also shorter than that in the control group,but there was no difference between the two groups(P > 0.05),the duration of the second stage of labor in the patient-controlled epidural analgesia group was longer than that in the control group,but there was no difference among the two groups(P >0.05).There was no difference in the duration of the third stage of labor among the three groups(P > 0.05).4.The rate of oxytocin utilization in the transcutaneous electrical acupoint stimulation group and the control group was significantly lower than that in the patient-controlled epidural analgesia group(P < 0.01,P < 0.01),but there was no difference between the transcutaneous electrical acupoint stimulation group and the control group(P > 0.05).The adverse reaction rate in the patient-controlled epidural analgesia group was significantly higher than that in the transcutaneous electrical acupoint stimulation group and the control group(P < 0.01,P < 0.01),but there was no difference between the transcutaneous electrical acupoint stimulation group and the control group(P > 0.05).5.There was no difference in the rate of cesarean section among the three groups after analgesia(P > 0.05).6.Among the parturients with vaginal delivery,there was no difference in the amount of postpartum hemorrhage and neonatal 1-minute and 5-minute Apgar score among the three groups(P > 0.05).Conclusion:1.The transcutaneous electrical acupoint stimulation can achieve effective labor analgesia.2.The transcutaneous electrical acupoint stimulation may promote the production of endogenous analgesic substance ?-endorphin and participate in analgesia.3.The duration of the transcutaneous electrical acupoint stimulation was significantly shorter than epidural block in the first and second stage of labor,and did not increase the rate of oxytocin utilization,the rate of cesarean section,and no obvious maternal and fetal adverse reactions.4.Although the analgesic effect of the transcutaneous electrical acupoint stimulation is lower than epidural block,it can obviously reduce labor pain to the degree of maternal tolerance,and it is non-invasive,economical and easy to operate,so it is worth popularizing,especially suitable for primary hospitals.