The comparison of intermittent epidural bolus and continuous epidural infusion mode on labor analgesia

目的 比较硬膜外间歇脉冲输注与持续背景量输注两种模式用于分娩镇痛,对镇痛效果、分娩方式及新生儿结局的影响是否有所不同.方法 本研究是一项回顾性队列研究.按照镇痛方案分成两组,即持续背景输注联合患者自控给药组(CEI+PCEA组,n=245)和硬膜外间歇脉冲输注联合患者自控给药组(IEB+PCEA组,n=258).收集相关资料,分析不同镇痛方案对围产期事件的影响.结果IEB+PCEA组每小时罗哌卡因用药量及舒芬太尼用药量明显少于CEI+PCEA组,自控按压次数和有效给药次数明显少于CEI+PCEA组.两组在产妇的最终分娩方式和新生儿出生后低Apgar评分比例方面差异均无统计学意义.结论 与持续背景输注模式相比,硬膜外间歇脉冲输注模式镇痛效果更好,且对最终分娩方式及新生儿结局无不良影响.Objective To compare the difference between intermittent epidural bolus(IEB) combined with patient controlled epidural analgesia(PCEA)and continuous epidural infusion(CEI)combined with PCEA mode in labor analgesia. Methods It was a retrospective cohort study ,which subjects were assigned to CEI+PCEA and IEB + PCEA group. Correlated data were collected to compare the effect of the two analgesic mode on perinatal events. Results There were less consumption of ropivacaine and sufentanil per hour ,less PCEA request and actual bolus in IEB + PCEA group. There were no significant difference between the delivery mode and the percentage of low Apgar score in neonates. Conclusion IEB+PCEA mode has better analgesic effect ,meanwhile doesn't disturb the delivery mode has no effect on the neonate outcome.152542-25453