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Acupoint Injection Decreases Anesthetic Cosumption during Combined Spinal-Epidural and Patient-Controlled Epidural Labor Analgesia
- Chinese Journal of Integrative Medicine Vol. 28, Issue 3, Pages: 257-262(2022)
- Affiliations：
1.Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou (510630), China
2.Medical College of Acupuncture-Moxibustion and Rehabilitation,Guangzhou University of Chinese Medicine, Guangzhou (510006),China
3.Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou (510630), China
- Author bio：
Prof. WU Ling-ling, E-mail: wulingling2003@163.com
- Funds：
DOI：10.1007/s11655-021-3501-8
CLC：Published：01 March 2022，
Published Online：03 November 2021，
Accepted：05 March 2021
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Min-li, 敏丽 HUANG, 黄, et al. Acupoint Injection Decreases Anesthetic Cosumption during Combined Spinal-Epidural and Patient-Controlled Epidural Labor Analgesia. [J]. Chinese Journal of Integrative Medicine 28(3):257-262(2022)
Min-li, 敏丽 HUANG, 黄, et al. Acupoint Injection Decreases Anesthetic Cosumption during Combined Spinal-Epidural and Patient-Controlled Epidural Labor Analgesia. [J]. Chinese Journal of Integrative Medicine 28(3):257-262(2022) DOI： 10.1007/s11655-021-3501-8.
摘要
目的:
2
探讨穴位注射能否改善采用腰硬联合麻醉 (combined spinal-epidural analgesia
CSEA) 及自控硬膜外麻醉 (patient-controlled epidural analgesia
PCEA) 实施分娩镇痛产妇的镇痛效果及分娩结局.
方法:
2
前瞻性收集2017 年7月至2019年12月期间病例共307例
按照随机数字表法将产妇随机分为穴位注射联合CSEA+ PCEA组 (AICP组
n=168) 和CSEA+ PCEA组 (CP组
n=139) . 两组产妇均在宫口扩张3 cm实施CSEA+ PCEA
AICP组病人同时选取双侧足三里 (ST 36) 和三阴交 (SP 6) 实施穴位注射. 主要结果是视觉模拟量表 (Visual Analogue Scale
VAS) 评分
次要结果是分娩结局及麻醉药物剂量. 所有产妇实施干预后均进行安全性评价.
结果:
2
AICP组产妇在实施分娩镇痛10、30、60、120分钟时的VAS评分均低于CP组 (
P
均
<
0.05) ; AICP组产妇潜伏期较CP组缩短 (
P
<
0.05) ; AICP组产妇的麻醉药物剂量及宫缩乏力、发热、瘙痒、尿潴留的发生率均低于CP组 (
P
均
<
0.05) .
结论:
2
穴位注射联合CSEA+ PCEA实施分娩镇痛可减少麻醉药物剂量
改善镇痛效果并降低副作用的发生率. (注册号: ChiMCTR-2000003120)
Abstract
Objective:
2
To explore if acupoint injection can improve analgesic effects or delivery outcomes in parturients who received combined spinal-epidural analgesia (CSEA) and patient-controlled epidural analgesia (PCEA) for labor analgesia.
Methods:
2
A total of 307 participants were prospectively collected from July 2017 to December 2019. The participants were randomized into the combined acupoint injection with CSEA plus PCEA group (AICP group
n
=168) and CSEA plus PCEA group (CP group
n
=139) for labor analgesia using a random number table. Both groups received CSEA plus PCEA at cervical dilation 3 cm during labor process
and parturients of the AICP group were implemented acupoint injection for which bilateral acupoint of Zusanli (ST 36) and Sanyinjiao (SP 6) were selected in addition. The primary outcome was Visual Analogue Scale (VAS) score
and the secondary outcomes were obstetric outcomes and requirement of anesthetics doses. Safety evaluations were performed after intervention.
Results:
2
The VAS scores were significantly lower in the AICP group than in the CP group at 10
30
60
and 120 min after labor analgesia (all
P
<
0.05). The latent phase of the AICP group was shorter than that of the CP group (
P
<
0.05). There were less additional anesthetics consumption
lower incidences of uterine atony
fever
pruritus and urinary retention in the AICP group than those in the CP group (all
P
<
0.05).
Conclusion:
2
Acupoint injection combined CSEA plus PCEA for labor analgesia can decrease the anesthetic consumption
improve analgesic quality
and reduce adverse reactions in the parturients. (Registration No. ChiMCTR-2000003120)
关键词
穴位注射腰硬联合麻醉分娩镇痛麻醉药物剂量多模式
Keywords
acupoint injectioncombined spinal-epidural analgesialabor analgesiaanesthetic consumptionmultimodal analgesia
references
Workie MM, Chekol WB, Fentie DY, Ahmed SA, Bizuneh YB. Assessment of awareness, attitude and desire for labor analgesia and associated factors among pregnant women in Ethiopia: a cross-sectional study. Pain Ther 2021;10:363-376.
Wang F, Cao YX, Ke SG, Zhu TH, Zhang M. Effect of combined spinal-epidural analgesia in labor on frequency of emergency cesarean delivery among nulliparous Chinese women. Int J Gynaecol Obstet 2016;135:259-263.
Cheng J, Rosenquist RW, eds. Fundament pain medicine.Cham, Switzerland: Springer; 2018:127-140.
Braga AFA, Carvalho VH, Braga FSDS, Pereira RIC.Combined spinal-epidural block for labor analgesia.Comparative study with continuous epidural block. Rev Bras Anestesiol 2019;69:7-12.
Wang Y, Xu M. Comparison of ropivacaine combined with sufentanil for epidural anesthesia and spinal-epidural anesthesia in labor analgesia. BMC Anesthesiol 2020;20:1.
Koyyalamudi V, Sidhu G, Cornett EM, Nguyen V, Labrie-Brown C, Fox CJ, et al. New labor pain treatment options.Curr Pain Headache Rep 2016;20:11.
Grangier L, Martinez de Tejada B, Savoldelli GL, Irion O,Haller G. Adverse side effects and route of administration of opioids in combined spinal-epidural analgesia for labour:a meta-analysis of randomised trials. Int J Obstet Anesth 2020;41:83-103.
Chen T, Zhang WW, Chu YX, Wang YQ. Acupuncture for pain management: molecular mechanisms of action. Am J Chin Med 2020;48:793-811.
Lee N, Martensson LB, Homer C, Webster J, Gibbons K, Stapleton H, et al. Impact on caesarean section rates following injections of sterile water (ICARIS): a multicentre randomised controlled trial. BMC Pregnancy Childbirth 2013;13:105.
Fouly H, Herdan R, Habib D, Yeh C. Effectiveness of injecting lower dose subcutaneous sterile water versus saline to relief labor back pain: randomized controlled trial.Eur J Midwifery 2018;2:3.
Wang F, Jia C, Ma T, eds. Acupuncture and moxibustion.2nd ed. Shanghai: Shanghai Scientific Technical Publishers; 2013:147.
Hekmatzadeh SF, Bazarganipour F, Allan H, Aramesh S, Mohammadi J. Effects of boiled dill seed on anxiety during labor: a randomized clinical trial. Chin J Integr Med 2020;26:100-105.
Khanna P, Jain S, Thariani K, Sharma S, Singh AK.Epidural fever: hiding in the shadows. Turk J Anaesthesiol Reanim 2020;48:350-355.
Kurd MF, Kreitz T, Schroeder G, Vaccaro AR. The role of multimodal analgesia in spine surgery. J Am Acad Orthop Surg 2017;25:260-268.
Kaye AD, Urman RD, Vadivelu N, eds. Essentials of regional anesthesia. 2nd ed. New York: Springer;2018:397-429.
Ondrejkovičová A, Petrovics G, Svitková K, Bajteková B,Bangha O. Why acupuncture in pain treatment? Neur Endocrinol Lett 2016;37:163-168.
Bonapace J, Gagne GP, Chaillet N, Gagnon R, Hebert E,Buckley S. No. 355-physiologic basis of pain in labour and delivery: an evidence-based approach to its management.J Obstet Gynaecol Can 2018;40:227-245.
Skilnand E, Fossen D, Heiberg E. Acupuncture in the management of pain in labor. Acta Obstet Gynecol Scand 2002;81:943-948.
Martensson LB, Hutton EK, Lee N, Kildea S, Gao Y, Bergh I.Sterile water injections for childbirth pain: an evidenced based guide to practice. Women Birth 2018;31:380-385.
Wu LL, Liu XH, Yin YZ, Sun K, Wu L, Yi W, et al.Effectiveness of acupuncture versus spinal-epidural anesthesia on labor pain: a randomized controlled trial. J Tradit Chin Med 2017;37:629-635.
Genç Koyucu R, Demirci N, Ender Yumru A, Salman S,Ayanoǧlu YT, Tosun Y, et al. Effects of intradermal sterile water injections in women with low back pain in labor:a randomized, controlled, clinical trial. Balkan Med J 2018;35:148-154.
Chau A, Bibbo C, Huang CC, Elterman KG, Cappiello EC,Robinson JN, et al. Dural puncture epidural technique improves labor analgesia quality with fewer side effects compared with epidural and combined spinal epidural techniques: a randomized clinical trial. Anesth Analg 2017;124:560-569.
Lim G, Facco FL, Nathan N, Waters JH, Wong CA,Eltzschig HK. A review of the impact of obstetric anesthesia on maternal and neonatal outcomes. Anesthesiology 2018;129:192-215.
Goetzl L. Epidural analgesia and maternal fever: a clinical and research update. Curr Opin Anaesthesiol 2012;25:292-299.
Riley LE, Celi AC, Onderdonk AB, Roberts DJ, Johnson LC,Tsen LC, et al. Association of epidural-related fever and noninfectious inflammation in term labor. Obstet Gynecol 2011;117:588-595.
Armstrong S, Fernando R. Side effects and efficacy of neuraxial opioids in pregnant patients at delivery: a comprehensive review. Drug Saf 2016;39:381-399.
Li Q, Zhu S, Xiao X. The risk factors of postpartum urinary retention after vaginal delivery: a systematic review. Int J Nurs Sci 2020;7:484-492.
Tang C, Jiang H, Liu F. Observation on the clinical efficacy of neostigmine for acupoint injection at Zusanli in the treatment of postpartum urinary retention. Clin Med Engin(Chin) 2019;26:217-218.
Yu KW, Lin CL, Hung CC, Chou EC, Hsieh YL, et al.Effects of electroacupuncture on recent stroke inpatients with incomplete bladder emptying: a preliminary study. Clin Interv Aging 2012;7:469-474.
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