Effects of Low-Dose Remifentanil Analgesia Combined with Water Birth on Maternal and Neonatal Utcome

Objective:To explore the feasibility of the intravenous infusion of low-dose remifentanil combined with water birth,and to evaluate its effect on the maternal and neonatal outcome.Methods:One hundred and sixty parturients of ASA Ⅰ-Ⅱ who choose vaginal delivery were allocated randomly into four groups.Group A did not adopt labor analgesia.The other groups underwent controlled intravenous infusion of remifentanil with different rates at 0.02 μg/(kg·min)(group B),0.02 μg/(kg·min) + water birth(group C),and 0.04 μg/(kg·min)(group D).Visual analogue pain score(VAS) in the process of delivery was assessed.The average time of maternal first stage and second stage,the rate of episiotomy,the cesarean section rate,the postpartum 2h bleeding and the total use of remifentanil were also recorded.The labor analgesia maternal side effects,the neonatal umbilical arterial blood gas analysis and neonatal Apgar scores were analyzed.Results:Compared with group A,the parturients in group C and group D had higher VAS scores after analgesia(P0.01),but both the side effects and the amount of postpartum hemorrhage in Group C were lower than that in other three groups(P0.05).There were no difference in Apgar score of neonates and umbilical arterial blood gas analysis among the four groups(P0.05).Conclusion:Low-dose remifentanil PCIA analgesia from the incubation period combined with water birth can reduce the concentration and total dose of remifentanil,the duration of first active period of labor time,and the occurrence of postpartum hemorrhage and cesarean section.It has little effect on Apgar score and umbilical arterial blood gas analysis of neonates.