PURPOSE

To analyze the application value of multimodal analgesia (MMA) regimen of patient-controlled epidural analgesia (PCEA) combined with multiacupoint stimulation analgesia during the whole stage of labor analgesia in primipara.

METHODS

300 primiparas with natural delivery were selected. According to the different ways of labor analgesia, they were divided into the first stage of labor active period PCEA group (group A), the whole stage of labor PCEA group (group W), and the whole stage of labor PCEA combined with multiacupoint stimulation analgesia group (group WM). The effect of MMA during the whole-labor process on maternal and infant safety was evaluated. The specific observation indicators were as follows: visual analogue scale (VAS) scores before analgesia ( ), at full opening of the uterus ( ), at the end of the second stage of labor ( ), and at the end of the third stage of labor ( ); stress response indicators at and : epinephrine (), norepinephrine (NE), glucose (Glu), and -endorphin (-EP) levels; delivery time of each stage of labor; the Apgar score of newborns at 1 and 5 min after birth; indicators of umbilical artery blood gas analysis immediately after delivery: PH value, base excess (BE), partial pressure of oxygen (PaO), and partial pressure of carbon dioxide (PaCO); incidence of postpartum depression (PPD) at 6 weeks after delivery.

RESULTS

At , , and , the VAS scores were lower in groups W and WM than in group A, and the VAS scores were lower in group WM than in group W ( < 0.05). At , there was no significant difference in the comparison of , NE, Glu, and -EP levels among the three groups ( > 0.05). At , the levels of , NE, Glu, and -EP were higher in the three groups than in the same group at , the levels of , NE, and Glu were lower, the levels of -EP were higher in groups W and WM than in group A, and the levels of -EP were higher in group WM than in group W ( < 0.05). Comparing the delivery time of the first stage of labor in the three groups, groups A and WM were shorter than group W ( < 0.05). Comparing the delivery time of the second and third stages of labor in the three groups, there was no significant difference ( > 0.05). Comparing the Apgar scores of the three groups of newborns at 1 and 5 min after birth, there was no significant difference ( > 0.05). Comparing the incidence of newborn asphyxia in the three groups, there was also no significant difference ( > 0.05). Comparing the PH, BE, PaO, and PaCO of three groups of newborns after delivery, there were no significant differences ( > 0.05). At 6 weeks after delivery, the incidence of PPD was lower in groups W (10.00%) and WM (8.00%) than in group A (20.00%) ( < 0.05).

CONCLUSION

The application of the MMA regimen of PCEA combined with multiacupoint stimulation for labor analgesia during the whole stage of labor in primipara can effectively reduce labor pain and stress response during the whole stage of labor and shorten the delivery time of the first stage of labor, the indicators of newborn Apgar score and umbilical artery blood gas analysis are not affected, and the incidence of PPD in patients is reduced, which can play a protective role for the safety of mother and infant.