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| Anesthetic effect of epidural intermittent and continuous administration of anaesthetic drugs for primipara with full term natural delivery |
1. The Eighth People's Hospital of Hefei, Chaohu, Anhui Province, 238000；2. Chaohu Hospital Affiliated to Anhui Medical University |
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Abstract To compare the anesthetic effects of regular epidural intermittent administration and continuous administration of anaesthetic drugs for primipara with full term natural deliver. Methods: 140 full-term natural delivery primipara were selected and were divided into two groups (70 cases in each group) according to the different mode of labor analgesia from January 2021 to March 2022. The primiparas in group A were given continuous epidural administration of anaesthetic drugs, and the primiparas in group B were given regular epidural intermittent administration of anaesthetic drugs. The pain score of visual analog scale (VAS), the body temperature value, and the IL-6 level of the primiparas before analgesia (T0), at the time of the orifice of the uterus opened to 3cm (T1) or to 7cm (T2), at the time of delivery (T3), or at the time of delivery of the baby (T4) were compared between the two groups. The dosage of ropivacaine and sufentanil used, the labor process, the proportion of intrapartum fever, the oxytocin application, the situations of artificial membrane rupture and instrument assisted delivery, and the incidences of lower limb motor nerve block and adverse pregnancy events of the primiparas were compared between the two groups. Results: There were no significant differences in the VAS score, the body temperature value, and the IL-6 level of the primiparas at T0 between the two groups (P＞0.05). The VAS score of the primiparas in group B at T1-T4 were significantly lower than those of the primiparas in group A (P<0.05). The body temperature value of the primiparas in both groups at T2, T3, or T4 was significantly higher than that at T0 (P<0.05). The IL-6 level of the primiparas in group B at T1-T4 were significantly lower than those in group A (P<0.05), and there was no significant difference in the rate of intrapartum fever (20.0% vs. 24.3%) of the primiparas between the two groups (P＞0.05). The dosages of ropivacaine used (61.3±9.8 mg) and sufentanil used (24.5±3.4μg) of the primiparas in group B were significantly lower than those (72.0±10.2 mg and 32.0±5.3μg) of the primiparas in group A. The duration of the first stage of labor (563.7±43.3 min) and the second stage of labor (48.5±9.6 min) of the primiparas in group B were significantly shorter than those (612.5±49.2 min and 63.2±11.4 min) of the primiparas in group A. The rate of delivery by instrumental assisted (8.6%) of the primiparas in group B was significantly lower than that (21.4%) of the primiparas in group A. The overall incidence (12.9%) of the adverse pregnancy events, such as fetal distress, postpartum hemorrhage, uterine rupture, and laceration of the birth canal, of the primiparas in group B was significantly lower than that (2.9%) of the primiparas in group A (all P<0.05). Conclusion: Compared with those of the continuous administration of the anesthetic drug, the regular epidural intermittent administration of the anesthetic drug of the primiparas during full term natural delivery can better relieve the labor pain, reduce the dosage of anesthetic drugs used, and shorten the labor process of the primiparas, and which has less impact on the motor nerve block of the primiparas, and therefore can improve the pregnancy outcomes of the primiparas.
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