5. COMPARISON OF THE ANALGESIC EFFECT OF CONTINUOUS ANAESTHESIA INFLATION WITH AUTOMATIC INTERVAL INJECTION OF SMALL DOSES (PIEB) IN EPIDURAL ANESTHESIA DURING LABOR

Tran Minh Long1, Bui Huu Hung1, Nguyen Quynh Trang1
1 Nghe An Maternity - Pediatric Hospital

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Abstract

Objective: To compare the pain relief effectiveness in labor of continuous anesthetic infusion method and automatic intermittent injection of small doses of anesthetic during epidural anesthesia.


Methods: Randomized clinical description with comparison. 100 patients were randomly distributed into 2 equal groups. The patient received L3-4 epidural anesthesia. After a test dose of 8 ml Ropivacaine 0.1% with fentanyl 1µg/ml (divided into 2 times / 5 minutes). Group P (PIEB) 8ml injected into the spinal cavity each time (Lockout 60 minutes). Group C (CEI) was run continuously at 8ml/60 min. If the VAS score is ≥ 4, the patient injects 6 ml of anesthetic (PCA). If the patient still has a VAS score ≥ 4, give a rescue dose of 6ml of Lidocaine 1%. The bolus dose in group P: 15 minutes after electric syringe bolus (VAS ≥ 4). Bolus dose in group C: dose for continuous infusion with VAS ≥ 4. Evaluation: Time to anesthesia induction, VAS pain score, rescue dose, lidocaine (mg), ropivacaine (mg) and fentanyl (µg), patient satisfaction.


Results: VAS scores at the time of cervical dilation, pushing stage, VAS at perineal stage and uterine control in group P were lower than in group C. Adding 1 rescue dose of group P (12%) was lower than that of group C (28%), Lidocaine group P (113.4 ±  33.6 mg) was lower than that of group C (128 ±  45.3 mg), Ropivacaine group P ( 47.8 ±  10.8 mg) was lower than that of group C (54.5 ± 11.4 mg), patient satisfaction in group P (96%) higher than group C (84%) with p < 0.05.


Conclusions: VAS score of group P is lower than group C, rescue dose, amount of anesthetic of group P is lower than group C. Satisfaction of pregnant women in group P (96%) was higher than in group C (84%), a difference statistically significant with p < 0.05

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References

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