Maternal And Neonatal Effects Of Programmed Intermittent Epidural Boluses Of Ropivacaine With Sufentanyl For Labour Analgesia

Objective To discuss the impact of programmed intermittent epidural boluses of ropivacaine with sufentanyl for labour analgesia on maternal and neonatal outcomes.Methods A total of 410 labour parturients with single pregnant and vertex present at full term in our hospital from October 2017 to September 2018 were included.According to the parity of randomly generated numbers by the computer,all participants were identified and categorized into two groups: epidrual analgesia at7 ml bolus per 1 hour(group PIEB)and epidrual analgesia with a continuous infusion at 7 ml/h(group CEI).The parturients were inerted with a lumbar epidural catheter(L2-3 or L3-4),loading bolus injected 10 ml mixed liquor 0.08% ropivacaine+ 0.4?g/ml sufentanyl,and then respectively administered with 0.08% ropivacaine with 0.4?g/ml sufentanyl.VAS score,frequency of women requiring rescue clinician boluses,the consumption of analgesics,maternal satisfaction from analgesia,duration of labour,instrumental vaginal delivery,lateral episiotomy,oxytocin usage and neonatal outcome were recorded.And we also recorded the incidence of adverse reaction on fever,vomit,pruritus and local anesthetic poisoning.Results Compared with group CEI,after about 120 minutes of the initial loading bolus,the VAS scores,the frequency of patients required rescue clinician boluses,the proportion of lateral episiotomy were lower,the consumption of 0.08% ropivacaine and 0.4 ?g/ml sufentanyl was smaller,the score of maternal satisfaction and the usage of oxytocin were higher,the duration of first stage of labour was longer in group PIEB(P<0.05).The incidence of adverse reaction on fever,vomit,pruritus and local anesthetic poisoning between PIEB and CEI has no difference.Conclusion The programmed intermittent epidural boluses decreases harm to maternal without any significant neonatal adverse effects.But group PIEB also prolong the duration of first stage of labour,in order to achieve better protection of maternal and child safety,we should pay more attention to the drug concentration,delivery speed and interval time.