Efficacy of different bolus dose of ropivacaine combined with sufentanil for programmed intermittent epidural bolus infusion in labor analgesia

Objective To observe the efficacy of different pulse dose of ropivacaine combined with sufentanil for programmed intermittent epidural bolus (PIEB) infusion in labor analgesia and its impact on maternal and neonatal safety.

Methods A total of 300 parturients undergoing labor analgesia were randomly divided into group A, group B, and group C, with 100 parturients in each group. The analgesic regimen consisted of 0.08% ropivacaine combined with 0.5 μg/mL sufentanil. The bolus infusion doses for groups A, B, and C were 6 mL, 8 mL, and 10 mL, respectively, with a bolus interval of 40 min. The patient-controlled analgesia (PCA) dose was the same as the corresponding bolus dose, with a lockout time of 15 min. The medication was discontinued after fetal delivery, with a limit dose of 30 mL/h. The Visual Analogue Scale (VAS) scores before analgesia (T₀) and at 30 min (T₁), 1 h (T₂), 2 h (T₃), 3 h (T₄) after analgesia, full dilation of the cervix (T₅), and immediately after delivery (T₆) were compared among groups. Additionally, the incidence of breakthrough pain, the first occurrence time of breakthrough pain, the rate of rescue analgesia, the number of PCA pump presses, delivery outcomes, and neonatal conditions were compared.

Results At each time points from T₁ to T₆, the VAS scores in all three groups were lower than that at T₀, and were lower in groups B and C than those in group A (P < 0.05). However, there was no statistically significant difference in VAS scores between groups B and C (P>0.05). The incidence of breakthrough pain, the rate of rescue analgesia, and the number of PCA pump presses were lower in the groups B and C than those in the group A, and the first occurrence time of breakthrough pain was later in groups B and C than those in group A (P < 0.05). There were no statistically significant differences among the three groups in neonatal birth weight, 1-min and 5-min Apgar scores, neonatal behavioral neurological assessment (NBNA) scores, and the incidence of neonatal asphyxia (P>0.05).

Conclusion 0.08% ropivacaine combined with 0.5 μg/mL sufentanil for PIEB in labor analgesia is safe and effective, with a bolus dose of 8 mL achieving good analgesic effects and having minimal impact on both mothers and neonates.