The application value of DPE combined with PIEB in labor analgesia after epidural perforation

ObjectiveTo investigate the safety and effectiveness of dural puncture epidural(DPE) analgesia combined with programmed epidural intermittent pulse injection(PIEB) in labor analgesia after epidural perforation.

MethodsSixty parturient women were randomly divided into group Atreatment with continuous epidural analgesia(CEA) combined with PIEB and group B(treatment with DPE combined with PIEB).The group A were treated with epidural puncture and catheterization.After successful epidural puncture, the 25G lumbar anesthetic needle was placed in group B, and the epidural tube was placed without injection after cerebrospinal fluid reflux was found.The drug formulation and PIEB settings in group B were the same as the group A.The visual analogue scale(VAS) scores and motor block in two groups before analgesia(T₀), after 5 minutes, 10 minutes, 15 minutes, 20 minutes and 1 hour of analgesia(T₁, T₂, T₃, T₄ and T₅, respectively), full cervical dilation(T₆) and during delivery of fetus(T₇) were recorded.The controlled epidur alanalgesia(PCEA) frequency, dosage of analgesic drug, analgesic adverse reactions, labor process, delivery results and maternal satisfaction were recorded in two groups.

ResultsThe labor analgesian in all parturient women were successfully performed, and the vital signs(including blood pressure, heart rate, pulse oxygen saturation and respiratory rate) and fetal heart rate in two groups were stable during the labor process(P>0.05).The VAS scores in two groups at T₁ to T₇ time points were significantly lower than at T0(P < 0.05), and the VAS scores in group B at T₁ to T₄ were significantly lower than those in group A(P < 0.05).There was no statistical significance in Apgar score, labor process and delivery method between two groups(P>0.05).The number of times of pressing analgesic pump and dosage of analgesics in group B were significantly less than those in group A(P < 0.05).The maternal satisfaction in group A was significantly higher than that in group B(P < 0.05).There was no statistical significance in postoperative modified Bromage between two groups(P>0.05), and there was no statistical significance in postoperative complications between two groups(P>0.05).

ConclusionsDPE combined with PIEB is a safe and effective method of analgesia, and which can be used for labor analgesia.