Abstract
Background: Childbirth is an incredibly joyful experience. However, labor is one of the most painful experiences that women go through in their life. Epidural analgesia with various ropivacaine administration methods aims to provide effective pain relief and comfort for laboring parturients.
Aims: To evaluate the analgesic efficacy of three epidural administration methods: intermittent epidural bolus, patient-controlled epidural analgesia and continuous epidural infusion.
Methods: A prospective comparative study was conducted on 150 parturients received epidural anesthesia during normal labor at Tu Du Hospital from July 2023 to July 2024. The study was divided into three groups, each consisting of 50 parturients: The intermittent group, which received an intermittent injection of 7ml of 0.1% ropivacaine + 2 mcg/ml fentanyl every 45 minutes; the control group, which maintained a low dose of anesthetic at 5 ml/hour and used PCA when experiencing pain; the continuous group, which maintained a continuous dose of anesthetic at 10 ml/hour. In all three groups, a rescue dose of 5 ml of anesthetic was administered when the patient experienced pain.
Results: Intermittent epidural bolus demonstrated the most effective pain relief. The average VAS score after epidural anesthesia and the percentage of patients with VAS ≥ 4 one hour post-epidural administratiion were significantly lower in the intermittent group compared to control group and continuous group (92%, 28%, and 66%; p < 0.05). The need for rescue doses in the intermittent and control groups was significantly lower compared to the continuous group (8% and 4% vs. 38%). The total anesthetic doses used were 46.5 mg in the intermittent group, 42.7 mg in the control group and highest in continuous group with 52.3 mg. Patient satisfaction was high, with 96% of parturients reporting being very satisfied and 4% moderately satisfied with the intermittent epidural bolus method. No significant differences in side effects were observed among the groups.
Conclusion: Intermittent epidural bolus provides superior pain relief during labor and should be considered for clinical application.
| Published | 2025-06-25 | |
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| Issue | Vol. 15 No. 3 (2025) | |
| Section | Original Articles | |
| DOI | 10.34071/jmp.2025.3.6 | |
| Keywords | gây tê ngoài màng cứng, tiêm ngắt quãng, bệnh nhân tự kiểm soát, truyền liên tục Epidural anesthesia, intermittent epidural bolus, patient-controlled epidural analgesia, continuous epidural infusion |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2025 Hue Journal of Medicine and Pharmacy
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