关键词: 间断硬膜外泵注, 自控硬膜外镇痛, 持续性硬膜外输注, 分娩镇痛

Abstract: Objective To compare the effects of regularintermittent epidural bolus （RIEB） and continuous epidural infusion （CEI） combined with patient-controlled epidural analgesia （PCEA） on labor analgesia. Methods 225 parturients who voluntarily received labor analgesia were randomly divided into three groups： A， B and C， 75 cases in each. Epidural analgesia was used for all the paturients， through L2-3 intervertebral space with 0.08% ropivacaine and 0.4 μg/ml sufentanil as epidural analgesic solution. In group A， CEI mode of analgesia was applied with 8 ml/h continuous infusion of analgesic solution. In the other two groups， RIEB mode of analgesia were used and after the first dose， 8 mL analgesic solution was injected epidural every one hour， on the speed of 2 ml/min in group B and 6 ml/min in group C respectively. Mean arterial pressure （MAP）， heart rate （HR） ， the visual analogue scale （VAS）， modified Bromage score were recorded at the following time points： before analgesia （T1）， 30 min after labor anesthesia （T2）， 60 min after labor anesthesia （T3）， datively cervix to 7-8 cm （T4）， full dilatation of cervix （T5）， at labor （T6）. Frequency of PCEA request， ropivacaine consumption， sufentanil consumption， total delivery duration，analgesic time，delivery mode， neonatal Apgar score， adverse reactions and parturients satisfaction score were observed. Results There was no significant difference in VAS score at T1， T2 and T3 among the three groups （P>0.05）. The VAS score at T4，T5 and T6，frequency of PCEA request， ropivacaine consumption， sufentanil consumption group C Group B > Group A （P<0.05）. There was no significant difference in MAP ， HR， modified Bromage score， total delivery time，analgesic time， delivery mode，adverse reactions，neonatal Apgar score， adverse reactions among the three groups（P>0.05）. Conclusion RIEB combined with PCEA is effective in labor analgesia， and the pump speed of 6ml/min is the best， which effectively decrease the need of PCEA and the dosage of analgesics and improve maternal satisfaction， without additional adverse reactions.

Key words: intermittent epidural bolus, labor analgesia, continuous epidural infusion, controlled epidural analgesia