Effect Of Programmed Intermittent Epidural Bolus And Continuous Epidural Infusion For Labor Analgesia

ObjectiveTo investigate the effects of programmed intermittent epidural bolus（PIEB）and continuous epidural infusion（CEI）for epidural labor analgesia.MethodsThis was a retrospective study.The nulliparae who were hospitalized in Shenzhen Baoan Maternity and Child Health Hospital and delivered successfully from January to December 2018 were retrospective analyzed.The nulliparae were divided into two groups according to the methods of analgesia:group C（received CEI combined with patient-controlled epidural analgesia（PCEA））and group P（received PIEB combined with PCEA）.NRS score before labor anesthesia（T₀）,30 min after labor anesthesia（T₁）,120min after labor anesthesia（T₂）,240 min after labor anesthesia（T₃）,the frequency of PCEA demand,the motor blockade status（modify bromage score）,maternal satisfaction,obstetric outcomes and adverse reaction were observed and recorded.ResultsAnalgesic effect:1.Compared with group C,the NRS score of group P was significantly decreased at T₃（P<0.05）.2.Compared with group C,the frequency of PCEA using,the total numbers and the valid numbers of pressing PCEA pump were significantly decreased in group P（P<0.05）.3.The maternal satisfaction of group P was significantly higher than that of group C（P<0.01）.4.Compared with group C,the motor blockade rate was significantly higher in group P（P<0.05）.Maternal outcomes:1.There was no significant difference in the delivery time between two groups（P>0.05）.2.There were no significant differences in delivery mode between two groups（P>0.05）.3.There were no significant differences in the incidence of complications including nausea/vomiting,pruritus,fever and indwelling catheter between the two groups（P>0.05）.Conclusions1.Both PIEB and CEI could achieve satisfactory analgesia effect with similar obstetric and newborn outcomes in both groups.However,PIEB could improving maternal satisfaction and decreasing the demand for PCEA and inhibiting breakthrough pain.2.Motor blockade was higher with 0.1%ropivacaine,suggesting that the PIEB regimen should be applied at a lower concentration and/or dose.