Clinical Application Of Ultrasound-Guided Epidural Catheterization In Individualized Length For Labor Analgesia

Objective: To investigate the effect and value of individualized length of ultrasound-guided epidural catheter placement in labor analgesia.Methods:100 puerperae who received labor analgesia were selected and divided into routine（A）group and ultrasound（U）group by random number table method.50 cases in each group.Group A was routinely punctured with an epidural catheter at a depth of 4 cm;Group U,ultrasound-guided epidural puncture was performed,and the depth of epidural catheter placement was the length of the L2 vertebral body.Connect the PCEA pump after securing the catheter.Comparing the range of anesthesia plane block 15 minutes after epidural injection between the two groups;VAS score before labor analgesia,30 minutes,60 minutes,and 90 minutes after pump operation;vertebral body length in group U;Adverse reaction of epidural catheter,（never stimulation sign,epidural catheter bleeding,crease,unilateral epidural block）;dosage of local anesthesia;number of analgesic pump compressions;maternal delivery mode;neonatal Apgar score at 1min,2min;maternal adverse events in each group reaction.Results: The range of anesthesia plane block in group U（5.24±1.89）was significantly higher than that in group A（4.26±1.86）.（p<0.05）;the VAS scores of group U at 30 min,60min,and 90 min were[（4.38±1.74）,（3.58±1.95）,（3.50±1.98）]points after running the pump,respectively were lower than group A [（5.50±2.10）,（4.46±1.98）,（4.30±1.91）] points（both p<0.05）;vertebral body length: the longest34 mm,the shortest 23mm;The incidence of nerve stimulation sign,unilateral epidural block,crease and catheter bleeding in group U were 2%,,4%,4%,0% were significantly lower than group A 18%,18%,16%,12%（all p < 0.05）.The amount of local anesthetic used in group U（62.82±12.19）ml was significantly lower than that in group A（77.64±11.90）ml（p<0.001）.The number of pump pressing times in group U（3.64±2.00）was significantly less than that in group A（4.38±1.74）（p<0.05）There was no significant difference in other observation indicators.Conclusions: Ultrasound-guided epidural catheterization with individualized length for labor analgesia can obtain a higher anesthesia block level,make the local anesthetic spread evenly,make the catheter length individualized for different patients,and reduce the incidence of catheter adverse events.Can reduce the use of analgesic drugs,reduce the number of analgesic pump pressing.There were no adverse effects on maternal and infant outcomes.Ultrasound-guided epidural catheterization with individualized length for labor analgesia has high value and is worthy of clinical promotion.