Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
Medical College of Acupuncture-Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.
Chin J Integr Med. 2022 Mar;28(3):257-262. doi: 10.1007/s11655-021-3501-8. Epub 2021 Nov 3.
To explore if acupoint injection can improve analgesic effects or delivery outcomes in parturients who received combined spinal-epidural analgesia (CSEA) and patient-controlled epidural analgesia (PCEA) for labor analgesia.
A total of 307 participants were prospectively collected from July 2017 to December 2019. The participants were randomized into the combined acupoint injection with CSEA plus PCEA group (AICP group, n=168) and CSEA plus PCEA group (CP group, n=139) for labor analgesia using a random number table. Both groups received CSEA plus PCEA at cervical dilation 3 cm during labor process, and parturients of the AICP group were implemented acupoint injection for which bilateral acupoint of Zusanli (ST 36) and Sanyinjiao (SP 6) were selected in addition. The primary outcome was Visual Analogue Scale (VAS) score, and the secondary outcomes were obstetric outcomes and requirement of anesthetics doses. Safety evaluations were performed after intervention.
The VAS scores were significantly lower in the AICP group than in the CP group at 10, 30, 60, and 120 min after labor analgesia (all P<0.05). The latent phase of the AICP group was shorter than that of the CP group (P<0.05). There were less additional anesthetics consumption, lower incidences of uterine atony, fever, pruritus and urinary retention in the AICP group than those in the CP group (all P<0.05).
Acupoint injection combined CSEA plus PCEA for labor analgesia can decrease the anesthetic consumption, improve analgesic quality, and reduce adverse reactions in the parturients. (Registration No. ChiMCTR-2000003120).
探讨穴位注射对接受腰硬联合麻醉（CSEA）和患者自控硬膜外镇痛（PCEA）联合分娩镇痛的产妇的镇痛效果和分娩结局的影响。
本研究前瞻性收集了 2017 年 7 月至 2019 年 12 月期间的 307 名参与者。采用随机数字表将参与者随机分为联合穴位注射 CSEA 加 PCEA 组（AICP 组，n=168）和 CSEA 加 PCEA 组（CP 组，n=139）进行分娩镇痛。两组产妇在宫颈扩张 3 cm 时均接受 CSEA 加 PCEA，AICP 组产妇在此基础上增加穴位注射，双侧足三里（ST 36）和三阴交（SP 6）穴位。主要结局指标为视觉模拟评分（VAS），次要结局指标为产科结局和麻醉药物剂量需求。干预后进行安全性评估。
镇痛后 10、30、60 和 120 min，AICP 组的 VAS 评分明显低于 CP 组（均 P<0.05）。AICP 组潜伏期短于 CP 组（P<0.05）。AICP 组产妇额外麻醉药物消耗较少，宫缩乏力、发热、瘙痒和尿潴留的发生率低于 CP 组（均 P<0.05）。
穴位注射联合 CSEA 加 PCEA 用于分娩镇痛可减少麻醉药物消耗，改善镇痛质量，减少产妇不良反应。（注册号：ChiMCTR-2000003120）。
