Comparison on the effect and adverse reaction of three methods of epidural infusion modes in labor analgesia of patients

Objective To compare the effects and adverse reaction of regular intermittent epidural bolus (RIEB) and continuous epidural infusion (CEI) combined with patient-controlled epidural analgesia (PCEA) on labor analgesia. Methods The clinical data of 255 patients in C.N. Maternity & Infant Health Hospital from June 2017 to January 2019 who had underwent labor analgesia were randomized into group A, B and C, with 85 cases in each group. Epidural analgesia was used for all the patients, through L3-4 intervertebral space with 0.08% ropivacaine and 0.4 μg/ml sulfentanylas epidural analgesic solution. In group A, CEI mode of analgesia was applied with 10 ml/h continuous infusion of analgesic solution. In the other two groups, RIEB mode of analgesia was used and after the first dose of 60 min, 10 ml analgesic solution was injected epidural every one hour at the speed of 2 ml/min in group B and 6 ml/min in group C respectively. The body temperature and visual analogue scale (VAS) score before analgesia (T1), 60 min after labor anesthesia (T2), at the time of datively cervix to 7-8 cm (T3) and at labor (T4) were compared among three groups. The frequency of PCEA request, ropivacaine consumption, sufentanil consumption, total delivery duration, analgesic time, delivery mode, neonatal Apgar score and adverse reactions were compared too. Results The body temperature at each time points had no significant differences (P>0.05). The VAS scores at T3, T4 in C group was the most highest, and then in B group was more higher, in A group was the lest, and there were significant differences among the three groups [T3: (1.4 ± 0.5) scores 0.05). Conclusions RIEB combined with PCEA is effective in labor analgesia, and the pump speed of 6 ml/min can effectively decrease the need of PCEA and the dosage of analgesics without additional adverse reactions. Key words: Anesthesia, obstetrical; Anesthetics, intravenous; Adverse reactions