The Influence And Meta-Analysis Of Epidural Analgesia And Transcutaneous Neuromuscular Electrical Stimulation On Pregnancy Outcome

Objective:1.To demonstrate the influence of patient-controlled epidural anesthesia(PCEA)and Transcutaneous neuromuscular electrical stimulation(TENS)on labor;2.A meta-analysis towards to EA and TENS to compare the efficacy and safety of both on childbirth,in order to provide theoretical basis for clinical.Method:1.Pregnant women who meet the inclusion and exclusion criterion in the obstetrics department of Lanzhou University Second Hospital from July 2017 to December 2018 were selected,among which 64 pregnancies were in patient-controlled epidural anesthesia group(PCEA group),80 in transcutaneous neuromuscular electrical stimulation group(TENS group),and 80 in control group in accordance with wishes of the patients.After it was arranged,the next process is to observe and record the stage of labor,1-minute and 5-minutes Apgar score after birth,neonatal weight,2 hours postpartum hemorrhage,pain score during labor,cesarean section rate,episiotomy rate,and forceps assisted rate of three groups with the data statistically analyzed by SPSS22.0.2.Wan Fang,Bai Du,CNKI,VIP,Elsevier,PubMed,Embase,Web of Science,Springer database were searched to identify the randomized contro1 led trials on EA and TENS in delivery up to 2018 Feb.Two reviewers screened,extracted data and evaluated the study quality independently according to the inclusion and exclusion criteria.Review Manager(version 5.3)software was used to analyze the data.Results:1.Compared with TENS group and the control group,the active period of the first stage and the second stage of labor were longer in the PCEA group.The PCEA group had better pain relief than the other groups.The TENS group had better pain relief than the control groups.The statistical difference were significant(P<0.05).2.There didn’t exist statistical difference in cesarean section rate,postpartum hemorrhage,the third stage of labor,newborn weight,asphyxiation rate,forceps assisted rate as well as episiotomy rate among three groups(P > 0.05).In addition,complications occurred more in thePCEA group than in other groups.3.The Review Manage 5.3 statistical software was used to analyze the statistic.Total of 1715 subjects were included in 8 literatures,including 868 cases of EA group and 847 cases of TENS group.The results of systematic analysis showed that the active period of the first stage of labor and the second stage of labor were shorter,the cesarean section rate was lower,the vaginal assisted delivery rate was lower and the incidence of newborns asphyxiation was lower in TENS group(P<0.05),but the relief of severe pain was better in EA group(P<0.000 1).The influence on moderate pain was uncertain(P=0.24).The statistical difference didn’t exist in 1-minute Apgar score and birth weight between the EA and TENS groups.Conclusion:1.Though EA may prolong the labor process,it showed best effect on severe pain relief.2.TENS group had better pain relief than the control group,and had no influence on the labor stage.3.In a word,either EA or TENS can alleviate the pain of childbirth and hand no influence on the third stage of labor and the 1-minute Apgar score.