| Objective: To investigate the analgesic effects of electro-acupuncture during incubation period of delivery on analgesia,safety and dosage of analgesic drug used in epidural block,so that to provide guidance for clinical analgesia of delivery.Methods :104 natural birth primiparas selected from our hospital were divided into three groups: group A(epidural anesthesia + electro-acupuncture)with 37 cases,group B(epidural + sham electro-acupuncture)with 36 cases,group C(epidural block)with 31 cases.Puerpera of group A were treated by stimulating Hegu and Sanyinjiao using Korean acupoint nerve stimulator to acupuncture analgesia from the dilatation of cervix to 1 cm to the beginning of the active stage(the dilatation of cervix to 3cm).Puerpera of group B were treated by stimulating shamly Hegu and Sanyinjiao using Korean acupoint nerve stimulator to acupuncture analgesia from the dilatation of cervix to 1 cm to beginning of the active stage(the dilatation of cervix to 3cm).Puerpera of group C were not treated by Korean acupoint nerve stimulator.Puerpera of three groups were all performed epidural block while the dilatation of cervix to 3 cm,and after the operation,mode of patient-controlled epidural analgesia was used.Analgesics setting: 100 ml solution containing 0.5μg / ml sufentanil and 1 mg / ml ropivacaine.Record visual analog scale(VAS)scores immediately after acupuncture(T0),1 hour(T1)after acupuncture,2 hours after acupuncture(T2),immediately after epidural anesthesia(T3),1 hour after epidural anesthesia(T4),2 hours after epidural anesthesia(T5),complete dilatation of cervix(T6);at T1,T2,T3,T4,maternal peripheral blood was collected for testing the concentrations of adrenocorticotropic hormone(ACTH),cortisol(COR)and β-endorphin(β-EP)concentrations,blood gas analysis of umbilical cord blood,record dosage of ropivacaine,oxytocin and sufentanil,the duration of production process,birth outcomes,adverse reactions,and newborns status.Results:(1)At T0,there was no statistically significant difference(P >0.05)on VAS scores between the three groups;(2)comparison of VAS scores between groups: Compared with group B and group C,VAS scores of group A at T1-T6 were significantly statistically lower(P <0.05);(3)comparison of VAS scores within groups: compared to T0,VAS scores of group A at each time point of T1-T6 were significantly statistically lower(P <0.05);but VAS scores of group B at each time point of T4-T6 decreased significantly compared with those at T0(P <0.05),as well as group C(P <0.05).(4)Postpartum hemorrhage: compared to group B and C,postpartum hemorrhage of group A in 24 hours after delivery was significantly less(P <0.05).(5)The production process and dosage of analgesic drug used in epidural block: the active phase,the third stage of labor and time of using oxytocin in group A were significantly shorter than those in group B and group C(P <0.05),dosage of ropivacaine and sufentanil,the total times of pressing analgesia pump and the efficacious times of pressing analgesia pump in group A were less than those in group B and group C(P <0.05).(6)The ACTH and COR concentration in maternal peripheral blood: compared with T1,concentrations of COR and ACTH in three groups at T2,T3,T6,respectively,were significantly higher(P <0.05),while concentrations of COR and ACTH in group A at T2,T3,T6 were significantly lower compared with group B and C,respectively(P <0.05).(7)β-endorphin concentration in maternal peripheral blood: concentrations of β-endorphin(β-EP)in group at T1-T3,T6,respectively were significantly higher than those in group B and C(P <0.05),and concentration of β-endorphin increased over time.Conclusions: The electro-acupuncture during incubation period of delivery can effectively relieve pain of women during childbirth,and suppress maternal stress response,shorten the birth process,strengthen efficacy of labor epidural analgesia,reduce dosage of analgesic drug used in epidural block and postpartum hemorrhage,maternal satisfaction is higher,no adverse effects on the fetus and newborn,which is one of safe prefeered non-drug methods of analgesia. |
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