SO SÁNH HIỆU QUẢ GIẢM ĐAU CỦA PHƯƠNG PHÁP TRUYỀN THUỐC TÊ LIÊN TỤC VỚI PHƯƠNG PHÁP TIÊM NGẮT QUÃNG TỰ ĐỘNG CÁC LIỀU THUỐC TÊ KHI GÂY TÊ NGOÀI MÀNG CỨNG GIẢM ĐAU TRONG CHUYỂN DẠ

Abstract

Objectives: A comparison the analgesic continuous epidural infusion (CEI) with programmed intermittent epidural boluses (PIEB) in primiparous labour. Subjects and methods: Prospective, randomized, comparative clinical trial, 100 pregnant women who received analgesia during labor by CEI and PIEB methods from November 2021 to May 2022 at Hanoi Obstetrics and Gynecology Hospital. BVPSHN). Both groups used a mixture of Ropivacaine 0.1% and fentanyl 2mg/ml. The CEI group (Group C) uses a continuous infusion pump, the PIEB group (Group P) injects automatically intermittently and automatically in small doses with an electric syringe with pre-set settings. Evaluation of the analgesic effect and the rate of additional rescue dose based on the VAS score at the time points before local anesthetic injection (H0), after reaching VAS<4 (H¬1), and 30 minutes after the first bolus dose (H0). H2) 1 hour after the first bolus dose (H3) end of stage I (H4) end of phase II (H5), end of stage III (H6) of labor. Results: VAS scores of the 2 groups after anesthesia were lower than at H0, the difference was statistically significant with p<0.01. At the time after injection from H1 to H4, the VAS score between group P and group C at the same time was lower, but the difference was not statistically significant with p > 0.05. The amount of local anesthetic Ropivacaine used in the study in group P was 32.76 ± 16.22 mg, which was low with group C at 40.32 ± 16.62. The amount of Fentanyl group P is 65.55 ± 32.53, lower than group C is 80.64 ± 33.24 mcg. The difference was statistically significant p<0.05. The number of SP requiring rescue dose of group P with 10% less than group C was 20%. Conclusion: Programmed intermittent epidural boluses for pain relief in labor is a method very good pain relief for pregnant women, reduce the use of anesthetic mixture compared to continuous epidural infusion and do not require much intervention of medical staff.