LI Mao-jun, WANG Jian, WEI Bin-xiu, et al. Effect and safety of electroacupuncture analgesia at the latent stage of labor on the epidural analgesia[J]. Acupuncture research, 2020, 45(4): 325-329.
DOI:
LI Mao-jun, WANG Jian, WEI Bin-xiu, et al. Effect and safety of electroacupuncture analgesia at the latent stage of labor on the epidural analgesia[J]. Acupuncture research, 2020, 45(4): 325-329. DOI: 10.13702/j.1000-0607.190448.
Effect and safety of electroacupuncture analgesia at the latent stage of labor on the epidural analgesia
Objective To investigate the effect of electroacupuncture(EA) analgesia at the latent stage of labor on epidural analgesia
labor outcome and neonatal score so as to provide the reference to the clinical labor analgesia. Methods According to the random number table
104 primipara of vaginal delivery were divided into three groups
named an EA group(37 cases)
a sham-EA group(36 cases) and an epidural block group(31 cases). In the EA group
when the cervix opened up by 1 cm
Han's acupoint nerve stimulation apparatus was attached to bilateral Hegu(LI4) and bilateral Sanyinjiao(SP6) to achieve EA analgesia till the active stage(the cervix up 3 cm). In the sham-EA group
the procedure was same as the EA group
but with the sham-stimulation. In the epidural block
EA was not used in intervention. When the cervix opened up 3 cm
the epidural block and the patient-controlled epidural analgesia were all adopted in each group. The score of visual analogue scale(VAS) and the dosage of Sufentanil and Ropivacaine in patient-controlled analgesia pump at the different time points were compared among the groups. Respectively
in 1 h of EA stimulation(T1)
2 h of EA stimulation(T2)
at the moment of epidural block(T3) and the complete open of the cervix(T6)
the venous blood sample was collected to determine the concentration of beta-endorphin(beta-EP)
and the use time of oxytocin
the bleeding amount and the state of newborn were recorded. Results There was no statistical difference in immediate of EA stimulation(T0) among the groups in VAS score(P>0.05). But
in T1 to T6
VAS score in the EA group was reduced obviously as compared with the sham-EA group and the epidural block group separately(P<0.05). There was no statistical difference in the use time of oxytocin among the three groups(P>0.05). In the sham-EA group and the epidural block group
bleeding amount during labor and in 24 h after labor was all higher than that of the EA group(P<0.05). In each group
the concentration of beta-EP in T3 and T6 was increased obviously as compared with that in T1 and T2 respectively(P<0.05). In the EA group
the concentration of beta-EP in T1 to T3 and in T6 was higher than that in sham-EA group and the epidural block group respectively(P<0.05). The dosage of Ropivacaine and Sufentanil in the EA group was less than that in either the sham-EA group or the epidural block group(P<0.05). There was no significant difference in amniotic fluid turbidity rate and Apgar score among the three groups(P>0.05). Conclusion Electroacupuncture analgesia at the latent stage of labor effectively relieves labor pain of primipara
increases the concentration of beta-EP
enhances the effect of epidural block analgesia
reduces labor bleeding and has no side effect on newborn. The combination of electroacupuncture analgesia and the epidural anesthesia in the latent stage is applicable in the whole process of labor.
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Related Author
LI Mao-jun
WEI Bin-xiu
DENG Qiu-xia
LIU Xin
ZHU Xiao-dong
ZHANG Ying
ZHU Tao
LI Jie
Related Institution
Department of Anesthesiology,Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University
College of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine
The Second Clinical Medicine College, Shanxi University of Chinese Medicine
Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences
Clinical Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine