Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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Randomized Controlled Trial
Clinical observation of regular intermittent epidural injection combined with different puncture points in suppressing breakthrough pain in labour analgesia.
The aim of the current study was to evaluate the clinical effects of the regular intermittent epidural injection combined with different puncture points (RIEI-dPP) in suppressing breakthrough pain during a labour analgesia. A total of 90 primipara were randomly divided into three groups (n = 30): Group L2-3 (A), Group L3-4 (B) and Group L4-5 (C). The analgesic pump parameters were set as: impact dose 8 mL, locking time 15 minutes, background dose 0, and the additional impact dose 8 mL after each hour intermittence. ⋯ What the implications are of these findings for clinical practice and/or further research? Compared with a continuous infusion, a regular intermittent epidural injection can achieve a more uniform drug distribution in the epidural space, so the block range can be more extensive, which can not only reduce the amount of anaesthetic but also effectively reduce the incidence of breakthrough pain. However, the selection of an intervertebral puncture site still lacks a uniform standard. The outcomes of this study can directly verify that regular intermittent epidural injection at L2-3, L3-4 and L4-5 can effectively inhibit breakthrough pain and achieve good analgesic effects, so selecting the intervertebral space with clear anatomical structure positioning and easier puncture pathway can benefit a labour analgesia.