The Application of Low-dose Remifentanil PCIA Analgesia from the Incubation Period Combined with Water Birth in Labor Analgesia

CHEN Xin-yan; FANG Xian-jie; LYU Chun-hua

doi:10.14033/j.cnki.cfmr.2016.25.001

Abstract：Objective:To observe the influence of low-dose Remifentanil PCIA analgesia from the incubation period combined with water birth in labor analgesia on puerperae and neonates.Method:One hundred and twenty cases of vaginal delivery primipara admitted to our hospital from October 2013 to October 2014 were selected as the objects and randomly divided into four groups:A group was given no labor analgesia,B group was given controlled intravenous infusion of low-dose Remifentanil of 0.02 μg/(kg·min),C group was given controlled intravenous infusion of low-dose Remifentanil of 0.02 μg/(kg·min) combined with water birth,D group was given controlled intravenous infusion of Remifentanil of 0.04 μg/(kg·min).The visual analogue pain score(VAS) was observed and the peripheral venous blood were sampled to detect the serum concentration of β-endorphin(β-EP) pre-administration and at the time of cervix was open 3 cm,5 cm, 10 cm.The side effects,postpartum 2 h bleeding,total usage of Remifentanil of puerperae and the neonatal Apgar score 1 min,5 min,10 min after birth as well as the usage rate of Naloxone among the four groups were recorded.Result:Compared to the A group,puerpants in other three groups had lower VAS scores after analgesia and lower concentration of peripheral venous blood β-EP,the differences were statistically significant(P<0.05).The episiotomy rate and the amount of postpartum 2 h bleeding of group C were lower than that in group B and group D,the differences were statistically significant(P<0.05).The Apgar score 1 min, 5 min after birth in group D were reduced,but after birth 10 min,the Apgar score of all the four groups were over 8 points.Conclusion:Low-dose Remifentanil PCIA analgesia from the incubation period combined with water birth can reduce the total dosage of Remifentanil and the postpartum 2 h bleeding and with no effect to the Apgar score of neonates.