Auricular bean embedding improves urination in epidural labor analgesia: A single center randomized controlled study.

BACKGROUND: Acupoint buried beans on the auricle is a feasible method to prevent and treat postpartum urinary retention. OBJECTIVE: This study investigated the effect of auricular acupoint buried beans on postpartum urination and maternal and fetal outcomes following epidural analgesia for labor. METHODS: Two hundred forty primiparas underwent vaginal trial labor analgesia from May 2020 to January 2021 and were randomly placed into the intervention and control groups. Both groups received epidural labor analgesia. Maternal urination during labor, 2 h postpartum, and the time for first postpartum urination were recorded as primary outcomes, with maternal and infant outcomes documented as secondary results. Statistical analysis was performed using the independent sample t-test, non-parametric rank-sum, or chi-square test using the SPSS Statistics 25.0 software. RESULTS: Two hundred eight study participants were subsequently included in the results, i.e., 105 patients in the intervention group and 103 in the control group. The intervention group comprised a significantly lower number of patients with excessive residual urine volume at cervical dilatation of 5-6 cm (P< 0.05). The total postpartum score of the intervention group was lower than in the control group (P< 0.01), and the time to first urination was shorter compared with the control group (P< 0.05). In the intervention group, the time of labor analgesia, the duration of the first stage of labor, and the total labor time were shorter compared with the control group (P< 0.01). CONCLUSION: Auricular acupoint embedded beans can improve the urination status at cervical dilatation of 5-6 cm and 2 h postpartum, as well as significantly shorten the duration of labor.

Combined spinal-epidural anesthesia with acupoint injection for labor anesthesia reduces IL-1ß/IL-10 ratio in maternal peripheral blood, umbilical cord blood and improves the labor outcomes: A prospective randomized controlled trial.

BACKGROUND: This study aimed to investigate the effects of combined spinal-epidural anesthesia (CSEA) with acupoint injection (AI) on the maternal-fetal expression of interleukin-1ß (IL-1ß), interleukin-10 (IL-10), analgesia effect, and labor outcomes. METHODS: A total of 360 healthy primiparas were randomized into the CSEA+AI group, the CSEA group, the AI group, and the control group (n = 90, each group) according to the labor analgesia methods. RESULTS: Compared to the CSEA group, the CSEA+AI group had significantly lower visual analog scale (VAS) scores, adverse events, dose of ropivacaine/sufentanil, and shorter labor durations. The IL-1ß/IL-10 ratio in maternal peripheral blood and umbilical cord blood was reduced in the CSEA+AI group compared with the CSEA group. CONCLUSION: The combination of CSEA and AI can reduce the ratio of IL-1ß/ IL-10 in maternal peripheral blood and umbilical cord blood, which can effectively relieve labor pain.

Acupoint Injection Decreases Anesthetic Cosumption during Combined Spinal-Epidural and Patient-Controlled Epidural Labor Analgesia.

OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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).

Acupoint Injection Decreases Anesthetic Cosumption during Combined Spinal-Epidural and Patient-Controlled Epidural Labor Analgesia / 中国结合医学杂志

OBJECTIVE@#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.@*METHODS@#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.@*RESULTS@#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).@*CONCLUSION@#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).

[Effect of transcutaneous electrical acupoint stimulation on epidural-related maternal fever in parturients undergoing epidural labor analgesia].

OBJECTIVE: To evaluate the therapeutic effect and safety of transcutaneous electrical acupoint stimulation (TEAS) on epidural-related maternal fever in parturients undergoing epidural labor analgesia. METHODS: A total of 198 primiparas with single birth, full-term pregnancy and head position were recruited and randomized into a TEAS group (98 cases) and a control group (100 cases). In the TEAS group, after epidural labor analgesia, TEAS was applied to bilateral Hegu (LI4) and Quchi (LI11), once an hour, for 30 min each time, till the end of childbirth. In the control group, after epidural labor analgesia, TEAS electrodes were attached to the same acupoints, but without electric stimulation. Maternal tympanic temperature and the score of Visual Analogue Score (VAS) were measured before analgesia, at 1, 2, 3, 4 and 5 h after analgesia and during labor respectively and maternal fever rate was evaluated in the parturients of two groups. Separately, before analgesia, 2 h after analgesia and during labor, the levels of serum interleukin (IL-6) and IL-1ß were determined in the parturients of two groups. The duration of labor, the mode of labor, oxytocin dosage, postpartum hemorrhage, neonatal Apgar scores, time of labor analgesia, labor analgesic consumption and adverse effects were recorded in the parturients of two groups. RESULTS: Maternal tympanic temperature increased progressively in two groups as analgesic time prolonged. Tympanic temperature at 3, 4 and 5 h after analgesia and du-ring labor, and maternal fever rate during labor in the TEAS group were all lower than those in the control group respectively (P<0.05). The levels of serum IL-6 and IL-1ß increased after analgesia in the parturients of two groups. The serum IL-6 level during labor and the level of IL-1ß at 2 h after analgesia and during labor in the parturients of the TEAS group were lower than those in the control group (P<0.05). The analgesic consumption in the TEAS group was less than that in the control group (P<0.05). The incidence of chills in the TEAS group was lower than that in the control group (P<0.05). The differences were not statistical in VAS score, duration of labor, mode of labor, oxytocin dosage, postpartum hemorrhage, time of labor analgesia and neonatal Apgar score, as well as the incidence of urine retention, nausea and vomiting and urinary retention between two groups (P>0.05). CONCLUSION: Transcutaneous electrical acupoint stimulation at LI11 and LI4 is conductive to relieving epidural-rela-ted maternal fever and reducing serum levels of IL-6 and IL-1ß in the parturients undergoing epidural labor analgesia. It is safe and effective in clinical application.

[Effect of transcutaneous electrical acupoint stimulation combined with epidural labor analgesia on postpartum depression].

OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS)combined with epidural analgesia on postpartum depression and to explore its underlying mechanism. METHODS: One hundred and twenty cases of full-term primiparous women with singleton pregnancy were selected from May 2018 to November 2018 in Jinzhong Maternal and Child Health Hospital. The parturients with labor analgesia requirement were randomly divided into the epidural group and the combination group, and the parturients without labor analgesia requirement were used as the control group, with 40 cases in each group. Patients in the control group did not receive labor analgesia and were treated according to the routine procedures of natural delivery; patients in the epidural group received epidural labor analgesia; patients in the combination group received TEAS at bilateral Hegu(LI4), Sanyinjiao(SP6) and Zusanli(ST36) (2 Hz/100 Hz, the current intensity is gradually increased from 15 mA, and the treatment was performed every 2 h, 20 min each time) combined with epidural labor analgesia. The visual analogue scale (VAS) scores were recorded when the uterine orifice opened to 3, 6, 8, 10 cm. Plasma glutamate was measured using high-performance liquid chromatography before analgesia, at the end of the third stage of labor and 42 days after delivery, and Edinburgh postnatal depression scale (EPDS) score was measured at 42 days after delivery. RESULTS: In comparison with the control group, the VAS score, EPDS score and the incidence of postpartum depression of the epidural group and the combination group were significantly lower(P<0.05), and the combination group had significant decrease than those in epidural group (P<0.05). Immediately before analgesia, there was no statistically significant difference in glutamate levels among the 3 groups (P>0.05). Compared with the control group, at the end of the third stage of labor and 42 days postpartum, the glutamate levels of the epidural group and the combination group were significantly reduced(P<0.05), and the combination group decreased more significantly than the epidural group (P<0.05). CONCLUSION: TEAS combined with epidural analgesia can reduce the incidence of postpartum depression, possibly by down-regulating plasma glutamate level and relieving of labor pain.

[Effect and safety of electroacupuncture analgesia at the latent stage of labor on the epidural analgesia].

OBJECTIVE: To investigate the effect of electroacupuncture (EA) analgesia at the latent stage of labor on epidural analgesia, labor outcome and neonatal score so as to provide the reference to the clinical labor analgesia. METHODS: According to the random number table, 104 primipara of vaginal delivery were divided into three groups, named an EA group (37 cases), a sham-EA group (36 cases) and an epidural block group (31 cases). In the EA group, when the cervix opened up by 1 cm, Han's acupoint nerve stimulation apparatus was attached to bilateral Hegu (LI4) and bilateral Sanyinjiao (SP6) to achieve EA analgesia till the active stage (the cervix up 3 cm). In the sham-EA group, the procedure was same as the EA group, but with the sham-stimulation. In the epidural block, EA was not used in intervention. When the cervix opened up 3 cm, the epidural block and the patient-controlled epidural analgesia were all adopted in each group. The score of visual analogue scale (VAS) and the dosage of Sufentanil and Ropivacaine in patient-controlled analgesia pump at the different time points were compared among the groups. Respectively, in 1 h of EA stimulation (T1), 2 h of EA stimulation (T2), at the moment of epidural block (T3) and the complete open of the cervix (T6), the venous blood sample was collected to determine the concentration of beta-endorphin (beta-EP), and the use time of oxytocin, the bleeding amount and the state of newborn were recorded. RESULTS: There was no statistical difference in immediate of EA stimulation (T0) among the groups in VAS score (P>0.05). But, in T1 to T6, VAS score in the EA group was reduced obviously as compared with the sham-EA group and the epidural block group separately (P<0.05). There was no statistical difference in the use time of oxytocin among the three groups (P>0.05). In the sham-EA group and the epidural block group, bleeding amount during labor and in 24 h after labor was all higher than that of the EA group (P<0.05). In each group, the concentration of beta-EP in T3 and T6 was increased obviously as compared with that in T1 and T2 respectively (P<0.05). In the EA group, the concentration of beta-EP in T1 to T3 and in T6 was higher than that in sham-EA group and the epidural block group respectively (P<0.05). The dosage of Ropivacaine and Sufentanil in the EA group was less than that in either the sham-EA group or the epidural block group (P<0.05). There was no significant difference in amniotic fluid turbidity rate and Apgar score among the three groups (P>0.05). CONCLUSION: Electroacupuncture analgesia at the latent stage of labor effectively relieves labor pain of primipara, increases the concentration of beta-EP, enhances the effect of epidural block analgesia, reduces labor bleeding and has no side effect on newborn. The combination of electroacupuncture analgesia and the epidural anesthesia in the latent stage is applicable in the whole process of labor.

[Effect of magnetic beads auricular point sticking therapy on intrapartum fever in primipara with epidural labor analgesia].

OBJECTIVE: To observe effect of magnetic beads auricular point sticking therapy on intrapartum fever in primipara with epidural labor analgesia and explore its possible mechanism. METHODS: A total of 160 primipara were randomly divided into an observation group (80 cases, 12 cases dropped off ) and a control group (80 cases, 15 cases dropped off ). The primipara in the control group received epidural labor analgesia. In the observation group, 15 min after epidural labor analgesia was performed, magnetic beads auricular point sticking therapy was given at shenmen (TF4), neishengzhiqi (TF2), neifenmi (CO18) and jiaogan (AH6a), pressing and kneading once every 15 min, 1 min each time, until the end of first stage of labor. The tympanic temperature on Ta (before labor analgesia), Tb (2 h after labor analgesia), Tc (4 h after labor analgesia) and Td (1 h after labor) was recorded, and the intrapartum fever incidence and level of serum cortisol and IL-6 between two groups were compared. The visual analogue scale (VAS) score before and after labor analgesia, the pressing times of patient controlled epidural analgesia (PCEA), and the dosage of sufentanil were observed. The active labor period, the second stage of labor, and the time of analgesia, the use of oxytocin, the number of vaginal examination and the rate of cesarean section were recorded in the two groups. RESULTS: There was no significant difference in tympanic temperature in the observation group at each time point (P>0.05), the tympanic temperature at Tc and Td in the control group was higher than that at Ta (P<0.05); the tympanic temperature at Tc and Td in the observation group was lower than that in the control group (P<0.05). The levels of serum cortisol and IL-6 at Td in the two groups were higher than those at Ta (P<0.05), and those in the observation group were lower than the control group (P<0.05). The second stage of labor in the observation group was shorter than that in the control group (P<0.05), and the pressing times of PCEA, the dosage of sufentanil, intrapartum fever incidence, usage rate and total amount of oxytocin and the number of vaginal examinations were all lower than those in the control group (P<0.05). CONCLUSION: Magnetic beads auricular point sticking therapy can reduce the amount of anesthetics, decrease the effect of epidural analgesia on primipara's body temperature regulation and labor progress, and lower the incidence of fever during labor analgesia by regulating the level of inflammatory response in the primipara.

Evaluating the effectiveness of TENS for maternal satisfaction in laboring parturients - Comparison with epidural analgesia.

BACKGROUND AND AIMS: Labor pain is one of the most severe pain that a woman experiences in her lifetime. Various methods are being used to relieve this pain and to achieve higher maternal satisfaction. One such technique is transcutaneous electrical nerve stimulation (TENS) that uses low-frequency electrotherapy. The aim of our study was to evaluate TENS by comparing it to an established labor analgesia technique, i.e., epidural analgesia in terms of maternal satisfaction. MATERIAL AND METHODS: This prospective study was conducted on 60 parturients in active stage of labor. The choice of analgesia was made by the parturient after informed consent. In group A (n = 30) TENS was used, while in group B (n = 30) epidural ropivacaine 0.125% + 2 µg/ml fentanyl was given. Continuous monitoring of maternal vitals, visual analogue score, and fetal heart rate (FHR) was done. Maternal satisfaction was scored considering pain relief, ability to move and experience of labor at the end of delivery and outcome was labeled as favorable and unfavorable. RESULTS: TENS was found to be favorable in 90% of parturients as compared to 96.6% in epidural (P 0.301). The number of highly satisfied parturients was 4 (13.3%) in TENS group and 17 (56.6%) in the epidural group (P= 0.000). Three patients in the epidural group had assisted delivery and two had cesarean section whereas all patients in TENS group delivered normally (P= 0.065). No significant difference was found in the fetal outcome. CONCLUSIONS: TENS is a good alternate choice for providing labor analgesia and may have a major role in future.

Effect and safety of electroacupuncture analgesia at the latent stage of labor on the epidural analgesia / 针刺研究

OBJECTIVE: To investigate the effect of electroacupuncture (EA) analgesia at the latent stage of labor on epidural analgesia, labor outcome and neonatal score so as to provide the reference to the clinical labor analgesia. METHODS: According to the random number table, 104 primipara of vaginal delivery were divided into three groups, named an EA group (37 cases), a sham-EA group (36 cases) and an epidural block group (31 cases). In the EA group, when the cervix opened up by 1 cm, Han's acupoint nerve stimulation apparatus was attached to bilateral Hegu (LI4) and bilateral Sanyinjiao (SP6) to achieve EA analgesia till the active stage (the cervix up 3 cm). In the sham-EA group, the procedure was same as the EA group, but with the sham-stimulation. In the epidural block, EA was not used in intervention. When the cervix opened up 3 cm, the epidural block and the patient-controlled epidural analgesia were all adopted in each group. The score of visual analogue scale (VAS) and the dosage of Sufentanil and Ropivacaine in patient-controlled analgesia pump at the different time points were compared among the groups. Respectively, in 1 h of EA stimulation (T1), 2 h of EA stimulation (T2), at the moment of epidural block (T3) and the complete open of the cervix (T6), the venous blood sample was collected to determine the concentration of beta-endorphin (beta-EP), and the use time of oxytocin, the bleeding amount and the state of newborn were recorded. RESULTS: There was no statistical difference in immediate of EA stimulation (T0) among the groups in VAS score (P>0.05). But, in T1 to T6, VAS score in the EA group was reduced obviously as compared with the sham-EA group and the epidural block group separately (P0.05). In the sham-EA group and the epidural block group, bleeding amount during labor and in 24 h after labor was all higher than that of the EA group (P0.05). CONCLUSION: Electroacupuncture analgesia at the latent stage of labor effectively relieves labor pain of primipara, increases the concentration of beta-EP, enhances the effect of epidural block analgesia, reduces labor bleeding and has no side effect on newborn. The combination of electroacupuncture analgesia and the epidural anesthesia in the latent stage is applicable in the whole process of labor.

Labor pain control and associated factors among women who gave birth at Leku primary hospital, southern Ethiopia.

OBJECTIVE: To assess labor pain control and associated factors among women who give birth at Leku primary hospital, southern Ethiopia, 2018/19. A systematic random sampling technique was used to select 404 mothers who gave birth at Leku hospital during the data collection period. Data were collected by two first degree midwives immediately after delivery using Labor Agentry Scale (LAS). RESULTS: In this study, 404 mothers were participated making the response rate of 100%. Among the participants, 104 (25.7%) of mothers reported Mild control of labor pain. Maternal age of 19 to 24 year AOR = 5.85 (95% CI 2.14, 15.98), being farmer AOR = 2.5 (1.14, 5.57), primi-para AOR = 0.13 (0.06, 0.3), good family support AOR = 2.8 (1.49, 5.3), short duration of labor (< 12 h) AOR = 3.2 (1.65, 6.23) and history of pregnancy loss AOR = 0.06 (0.03, 0.14) were significantly associated with greater control of labor pain. In general, compared to other studies, the level of labor pain control is good in this study area. Enhancing factors of labor pain control have to be strengthened to increase greater control of labor pain. Qualitative research is highly recommended to identify cultural factors related to labor pain control and management.

[Efficacy of Ropivacaine injection at acupoints for labor analgesia and its effect on breastfeeding and serum prolactin].

OBJECTIVE: To investigate the efficacy of acupoint injection of Ropivacaine for labor analgesia and its effect on breastfeeding and prolactin secretion. METHODS: A total of 80 primipara who asked to receive labor analgesia were randomized into epidural analgesia group (n＝35) and acupoint injection group (n＝36), and other 36 primipara who refused to receive labor analgesia were subjected to the control group. The labor analgesia began to be performed when the puerpera's uterine orifice opened about ≥3 cm (the first stage of labor), including puerpera controlled epidural analgesia (PCEA, Sufentainil ＋ 0.1% Ropivacaine hydrochloride, 5 µg/mL at L3-L4 interspace, till the birth of fetus) or acupoint injection of Ropivacaine (0.2%, 1 mL/acupoint) at bilateral Hegu (LI4) and Sanyinjiao (SP6). The delivery situations such as the duration of labor, and number of cases who used oxytocin, obstetric-forceps-aided delivery, cesarean delivery were recorded. The serum prolactin concentration was assayed by using ELISA. The visual analogue scale (VAS) scores at the time points of T0 (about 3 cm widening of the orifice of uterus and before performing analgesia), T1 (30 min after labor analgesia), T2(about 10 cm widening of the orifice of uterus) and T3(coming out of fetal head). The duration of labor, ratio of use of oxytocin, onset time of breastfeeding, and times of breastfeeding within 24 postpartum hours were recorded accordingly. RESULTS: The VAS scores at time-points of T1, T2 and T3 were significantly lower in both epidural analgesia and acupoint injection groups in comparison with their own T0 and the control group (P<0.05), and were also considerably higher in the acupoint injection group than in the epidural analgesia group (P<0.05). The duration of the 2nd stage of labor (from complete opening of the uterus orifice to complete birth of the fetus) was significantly longer, (P<0.05) and the number of oxytocin-using puerpera was obviously bigger in the epidural analgesia group than in the control group (P<0.05). After partum, the 1st breastfeeding time was obviously earlier and the frequency of breastfeeding notably increased in both epidural analgesia and acupoint injection groups than in the control group (P<0.05), the serum prolactin content was remarkably higher in the acupoint injection group than in the epidural analgesia group (P<0.05). No significant differences were found between the acupoint injection and the control groups in the duration of the 1st and 2nd stages of labor, and in the numbers of oxytocin-using puerpera, obstetric forceps-aided birth and cesarean delivery (P>0.05), and between the epidural analgesia group and control group in the serum prolactin levels (P>0.05)．. CONCLUSION: Injection of Ropivacaine at LI4 and SP6 is effective for labor analgesia and raising prolactin level, and favorable to breastfeeding in the early postpartum period.

Effects of electroacupuncture on reducing labor pain and complications in the labor analgesia process of combined spinal-epidural analgesia with patient-controlled epidural analgesia.

PURPOSE: To compare the pain scores and rates of complications in the labor analgesia process between the two groups. METHODS: There were 127 participants being recruited in this research, and randomly divided into 2 groups according to the anesthetic technique: CSEA with PCEA with EA group (group 1), CSEA with PCEA group (group 2). Group 1 was first operated CSEA and PCEA, then EA at Hegu (LI4), Neiguan (PC6), Zusanli (ST36) and Sanyinjiao (SP6) by HANS-200A device for 25 min. Group 2 was only treated by CSEA and PCEA. The main outcome was the VAS for labor pain. Meanwhile the complications, use of oxytocin, durations of three stages, delivery mode, cord blood pH and neonatus Apgar score in this study were considered as secondary outcomes. RESULTS: After labor analgesia, the VAS scores of group 1 at the five point-in-times were all lower than that of group 2. The rates of fever and urinary retention of group 1 were lower compared with group 2. Group 1 had less usage of oxytocin and shorter durations of cervical dilation from 3 to 10 cm and third stage than group 2. CONCLUSIONS: EA can help to reduce labor pain in CSEA with PCEA labor analgesia process, and may be able to reduce the complications.

Efficacy of aromatherapy for reducing pain during labor: a randomized controlled trial.

BACKGROUND: Many strategies for labor pain management have been studied, including aromatherapy, which is a noninvasive, alternative medicine used as an adjunct for labor pain control. Nevertheless, the results were contradictory. Therefore, we conducted this study to determine the effectiveness of aromatherapy for reducing pain during labor. METHODS: A randomized controlled trial was carried out on Thai laboring primigravidae who were a low-risk singleton pregnancy undergoing vaginal delivery. All participants, both study and control group, received standard obstetric care. Aromatherapy was only provided to the study group during the first stage of labor. The women rated their pain intensity by rating scales at different stages of labor. The primary outcome was pain scores and the secondary outcomes were necessity of painkiller usage, labor time, aromatherapy-associated complications, route of delivery, and Apgar scores. RESULTS: A total of 104 women were recruited, 52 in each group. Baseline characteristics and baseline pain scores were comparable. The median pain score of latent and early active phase was lower in the aromatherapy group, 5 vs 6 and 7 vs 8, respectively. The mean differences of pain scores between latent and early active phase and the baseline were significantly lower in the aromatherapy group, 1.88 vs 2.6 (p = 0.010) and 3.82 vs 4.39 (p = 0.031), respectively. Late active phase pain scores and other perinatal outcomes were not significantly different. CONCLUSION: Aromatherapy is helpful in reducing pain in latent and early active phase, and can probably be used as an adjunctive method for labor pain control without serious side effects.

Application and Security Observation of Acupuncture in Labor Analgesia / 上海针灸杂志

Objective To observe the therapeutic efficacy and safety of acupuncture and epidural anesthesia during full-term labor. Method A total of 199 eligible subjects experiencing natural labor were randomized into four groups. The acupuncture group was intervened by acupuncture at acupoints; the epidural group was given epidural anesthesia;the combined analgesia group was given acupuncture at acupoints plus epidural anesthesia; the control group was not given any interventions for analgesia. The Visual Analogue Scale (VAS) was adopted to record and compare labor pain (cervix dilation 3 cm at 0 min, 30 min, and 60 min, and at full cervix dilation); meanwhile, the active period of the first stage of labor, cervix dilation speed, the second stage of labor, Caesarean section (C-section) rate, instrumental delivery rate, Apgar score, and post-labor bleeding amount (2 h) were also recorded. The contents of blood β-endorphin (β-EP) and 5-hydroxytryptamine (5-HT) were monitored during the first stage of labor. Result Compared with the control group, the VAS scores dropped in the other three groups, and the decreases were similar in the epidural group and combined analgesia group, while the decrease in the acupuncture group was the least significant. Regarding the labor-related indexes, the cervix dilation speed was higher in the acupuncture group than in the control group(P0.05). There were no significant between-group differencesin comparing the post-labor bleeding amount and Apgar score of the new-born babies(P>0.05), but compared with the epidural group, there was no use of assisted delivery. The content of blood β-EP during the first stage of labor increased in the acupuncture group and combined analgesic group(P0.05). Conclusion Acupuncture analgesia can reduce labor pain and shorten labor duration without affecting the second stage of labor and security-related indexes.

Clinical effects comparison of ropivacaine combined with two doses of sufentanil on labor analgesia / 中国生化药物杂志

Objective To investigate clinical effects differences of ropivacaine combined with two doses of sufentanil on labor analgesia.Methods300 lying-in women with painless childbirth in the period from January 2016 to December 2016 in department of obstetrics in Deqing hospital of traditional Chinese medicine were chosen and randomly divided into two groups including A group (150 cases) with ropivacaine combined with conventional doses of sufentanil for 7.5μg and B group (150 cases) with ropivacaine combined with low doses of sufentanil for 2.5μg;the block onset time of sensory and motor, arrival time at the maximum block level, modified Bromage score, Apgar score, VAS score at different time points and adverse reaction rate of both groups were compared.ResultsTwo groups of maternal sensory and motor block work time and reach the highest block plane comparative differences had no statistical significance.The modified Bromage score of B group were significant better than A group(P<0.05).The adverse reaction rate of B group were significant lower than A group(P<0.05).ConclusionCompared with conventional dosage sufentanil, luo pp paid in combination with low dose used in epidural sufentanil analgesia can obviously reduce the working time, improve the quality of anesthesia and reduce the incidence of adverse reactions, is suitable for clinicians to choose application.

[Clinical observation of analgesia in delivery treated with acupoint pressure therapy].

OBJECTIVE: To observe the efficacy of acupoint pressure therapy on relieving labor pain in primiparas. METHODS: One hundred and twenty primiparas were randomized into an observation group (60 cases) and a control group (60 cases). In the observation group, Hegu (LI 4), Sanyinjiao (SP 6), Taichong (LR 3), Neiguan (PC 6), Ciliao (BL 32) and Zhongliao (BL 33) on bilateral sides were selected. The acupoint pressure therapy was applied when the uterine orifice was dilated to 2 to 3 cm. In the control group, the acupoint pressure therapy was not used. Separately, when the orifice was dilated as 2 to 3 cm, 5 to 6 cm, 7 to 8 cm and 9 to 10 cm, the pain response grade was assessed (including physician's analgesia score and patient's self-evaluation score of analge-sia). The in labor pain was observed and compared in the puerperas between the two groups. The time of the first, second and third stages of labor, the time of total stage of labor as well as the cesarean section rate were compared in the puerperas between the two groups. RESULTS: (1) Analgesic effect:when the uterine orifice was dilated as 2 to 3 cm, 5 to 6 cm, 7 to 8 cm and 9 to 10 cm, the self-evaluation scores of analgesia in the puerperas of the observation group at each time point were all apparently lower than those in the control groups (all P<0.05). In the observation group, for the physician's analgesia score, 213 person-times presented analgesic effect and 18 person-times no effect. In the control group, 178 person-times presented analgesic effect and 44 person-times no effect. The analgesic effect in the observation group was better than that in the control group (P<0.05). (2) Stages of labor:the differences in the second and third stages of labor were not significant statistically between the two groups (both P>0.05). The time of the first stage of labor and the time of the total stages of labor in the observation group were shorter appa-rently than those in the control group[(8.07±2.08)h vs (9.58±2.79)h, (8.91±2.80)h vs (10.51±2.83)h, both P<0.05]. (3) Cesarean section rate:the cesarean section rate in the observation group was lower than that in the control group[5.0% (3/60) vs 10.0% (6/60), P>0.05]. CONCLUSIONS: Acupoint pressure therapy has definite efficacy on relieving labor pain. It shortens the stages of labor and cesarean section rate.

The labor analgesia effect in combination of water acupuncture and remifentanil patient-controlled intra-venous analgesia (PCIA) onmother and baby / 实用医学杂志

Objective To studythe labor analgesia effect incombination of water acupuncture andremifen-tanil patient-controlled intravenous analgesia (PCIA) and impact on mother and baby. Methods 90 Ninety sin-gle birth primiparous women were randomly divided into three groups (n = 30), groupⅠ, groupⅡ, groupⅢ. Content of β-endorphin, stress hormone levels,VAS scores were recorded at T0 and T1; adverse circumstance, Apgar score of newborn and neonatal behavioral neurological assessment were recorded. Results Comparing with groupⅢ or T0, at T1 β-EP in the groupⅠwas gone up, while ACTH、 COR and VAS scores were lower in the groupⅠand groupⅡ; adverse circumstance in the groupⅠreduced than that in the groupⅡ. The VAS scores inThe groupⅠand groupⅡand Apgar score and NBNA assessment in three groups were not significantly different. Conclusion Combination of water acupuncture and remifentanil patient-controlled intravenous analgesia iseffec-tive. Ithas no adverse effects on mother and baby. It is an ideal method of labor analgesia.

Nonpharmacologic labor analgesia.

A supportive medical team should be well informed on the various pharmacologic and nonpharmacologic modalities of coping with or mitigating labor pain to appropriately support and respectfully care for parturients. Using the methodical rigor of previously published Cochrane systematic reviews, this summary evaluates and discusses the efficacy of nonpharmacologic labor analgesic interventions.