| Objective To explore the safety and effectiveness of programmed intermittent epidural bolus(PIEB)combined with optimized dural puncture epidural (DPE) anesthesia in maternal labor analgesia.Methods A total of 110 puerperae who underwent labor analgesia in Shenzhen Luohu People's Hospital and Xilin People's Hospital from December 2019 to December 2020 were selected.They were divided into the programmed intermittent epidural bolus group (group P,n=55) and the control group (group C,n=55) by using the random number table method.The scores of Visual Analogue Scale/Score(VAS),heart rate,mean arterial pressure (MAP),number of patient controlled epidural analgesia (PCEA) of puerperae before analgesia,and at 10 min,30 min,60 min and 90 min after analgesia as well as the second stage of labor were recorded.The cesarean section rate,instrument midwifery rate and Bromage score of puerperae,adverse reac tions [ARs (the deceleration rate of fetal heart,hypotension,nausea and vomiting,pruritus,neurological dysfunction)],and the Apgar score of the neonates at 1 min and 5 min after birth were also recorded.Results The MAP at 60 min after analgesia and the second stage of labor [(76.29±6.25)mmHg,80.32±6.59) mmHg],VAS score at the second stage of labor(1.49±1.12)points,and number of PECA (3.76±2.21)times in group P were all lower than those of group C[(79.31±7.10)mmHg,(82.84±5.81)mmHg],(1.49±1.12) points and (5.29±3.20)times,respectively],with statistically significant differences(P<0.05).There were no statistically significant differences between the two groups in mode of delivery,ARs and Apgar scores of the neonates(all P>0.05).Conclusion PIEB combined with DPE technique has a greater effect on MAP of puerperae and can provide better analgesia in the second stage of labor with less drug use.It has no adverse effects on obstetric outcomes,motor nerve block conditions,ARs and neonatal outcomes. |
