Comparison of the effects of programmed intermittent epidural bolus and continuous epidural infusion of ropivacaine for labor analgesia in latent phase

Abstract

Objective To compare the efficacy of programmed intermittent epidural bolus and continuous epidural infusion of ropivacaine in labor analgesia. Methods From May 2014 to May 2017, 170 patients, 24-32 years, for full-term primipara in the Maternal and Child Health Care Hospital of Quzhou were selected as study objects, and they were randomly divided into intermittent epidural injection group(T group) and continuous epidural pump group(C group) by computer random software, with 85 cases in each group.All patients were epidurally injected 2% lidocaine 3mL and 0.2% ropivacaine 2mL at the opening of the uterus, less than 3cm.T group was given programmed intermittent epidural bolus 0.1% ropivacaine 6mL/h.C group was given continuous epidural infusion 0.1% ropivacaine 6mL/h.The pain of maternal(NRS score) and motor block situation of maternal (Bromage score) were monitored.The number of PCEA, PCEA pressure times, the rate of instrumental delivery and APGAR score were also recorded. Results The number of Bromage score≥2 in C group was higher than that of T group at 4-10h after labor analgesia (3 cases vs.11 cases, 3 cases vs.15 cases, 4 cases vs.17 cases, 4 cases vs.18 cases, 6 cases vs.19 cases, 6 cases vs.21 cases, 7 cases vs.22 cases; χ2=4.982, 8.947, 9.182, 10.230, 7.926, 9.907, 9.354, all P 0.05). The number of PCEA, PCEA pressure times and the rate of instrumental delivery in T group were lower than those in C group [8 cases vs.18 cases, 22 cases vs.41 cases, (3.5±1.5)times vs.(4.9±2.2)times; χ2=4.541, 9.104; t=2.666, all P 0.05). Conclusion Compared with continuous epidural infusion, programmed intermittent bolus of ropivacaine for labor analgesia exerts good analgesic effect, it has minor effects on exercise function and can decrease the rate of instrumental delivery. Key words: Parturition; Analgesia, obstetrical; Analgesia, epidural; Analgesia, patient-controlled; Programmed intermittent bolus; Continuous epidural infusion; Apgar score