Application of PCEA combined with PIEB for labor analgesia in primiparas with gestational diabetes mellitus
WANG Mei
ZHANG Chunyuan
ZENG Wei
MA Jian
HUANG Zehui
XING Zeting
Abstract：Objective To evaluate the application efficacy of patient-controlled epidural analgesia(PCEA)com-bined with programmed intermittent epidural bolus(PIEB)for labor analgesia in primiparas with gestational diabetes melli-tus(GDM).Methods A total of 482 GDM primiparas planning vaginal delivery were enrolled and allocated into two groups:the PCEA group(n=240,receiving standard PCEA),and the PCEA+PIEB group(n=242,receiving the com-bined regimen of PCEA with PIEB).We compared the delivery mode,oxytocin use,duration of labor stages,intrapartum blood glucose levels,2-hour postpartum hemorrhage volume,incidence of adverse reactions,visual analogue scale(VAS)scores,and analgesic satisfaction of the two groups as well as neonatal height,weight,blood glucose,Apgar scores,umbili-cal artery blood gas parameters,and the proportion of admission to the neonatal intensive care unit(NICU).Results The PCEA+PIEB group demonstrated significantly lower VAS scores and reduced local anesthetic consumption at 1,2,and 3 h after analgesia initiation,at 7-8 cm cervical dilation,and at fetal delivery,compared to the PCEA group.Additionally,the combined regimen was associated with a shorter time to pain relief,a longer total analgesic duration,fewer patient-con-trolled bolus requests,and higher maternal satisfaction(all P<0.05).No significant intergroup differences were ob-served in delivery mode,oxytocin requirement,labor stage durations,maternal blood glucose levels,2-hour postpartum hemorrhage,or incidence of adverse reactions(all P>0.05).There was no statistically significant difference in height,weight,blood glucose,Apgar scores,umbilical artery blood gas values,or NICU admission rates between the two groups(all P>0.05).Conclusions For primiparas with GDM,the combined PCEA+PIEB regimen provides superior labor an-algesia,characterized by enhanced efficacy and higher maternal satisfaction,compared to PCEA alone.The impact of PCEA combined with PIEB on other maternal and infant outcomes is not significantly different from that of PCEA alone.
Keywords：gestational diabetes mellituspatient-controlled epidural analgesiaprogrammed intermittent epidural boluslabor analgesiavaginal deliveryprimipara
Publication Date：2025-12-25
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：5( 65-69 )