Clinical application of intelligent patient-controlled pump for labor analgesia

Abstract

Objective To evaluate the efficiency of intelligent patient-controlled pump for labor analgesia, and its influence on mothers and neonates. Methods One hundred and twenty primiparas were randomly divided into two groups(n=60), respectively utilizing intelligent(group I) and traditional(group T) patient-controlled pumps to deliver 0.1% ropivacaine plus 0.5 mg/L sufentanil for constant epidural analgesia. Both groups received an initial bolus of 12 ml analgesic solution, and the basic pump settings were 5 ml/h, 5 ml, 15 min for basal infusion rate, bolus dose, and lock time, respectively. In group T, the basic pump settings were used. In group I, the doses of analgesics were adjusted once every hour to meet patients demands for adequate analgesia. The pumps were stopped by the end of the second stage of labor. The follow outcome measures, including the VAS scores before maternal analgesia(T0), 15 min(T1), 30 min (T2), 2 h (T3) after analgesia, the full cervical dilatation(T4), and forced delivery at the second stage of labor(T5), delivery mode, the time of the second stage of labor, total duration of labor, total analgesia time, the usage of analgesics, hourly dosage, local anesthetic background infusion rate at delivery, the number of breakthrough pain, 1 min, 5 min Apgar score of the neonatal, the neonatal weight, side-effects as well as the maternal satisfaction, were recorded. Results We analyzed valid data from 113 parturient women(57 in group I and 56 in group T). Compared with group T, the VAS score at full cervical dilatation and the incidence of breakthrough pain in group I were significantly decreased(P<0.05), the infusion rate of analgesics during forced labor in group I was increased with better analgesia(P<0.05), there was no significant difference between two groups in, the usage of analgesics, the duration of labor, the mode of delivery, the condition of neonates, and the incidence of side-effects as well. Conclusions The intelligent patient-controlled analgesia pump is effective for labor analgesia. It lowers incidence of breakthrough pain and improves maternal satisfaction without increasing the dosage of analgesics and the risk of side-effects. Key words: Analgesia, obstetrical; The intelligent patient controlled analgesia pump; Patient controlled analgesia