Clinical study of transcutaneous electrical acupoint stimulation combined with ultrasound-guided pudendal nerve block in labor analgesia

Abstract:

Objective To investigate the effect of transcutaneous electrical acupoint stimulation（TEAS） combined with ultrasound-guided pudendal nerve block on analgesia and pregnancy outcome of pregnant women in vaginal delivery.Methods A total of 106 primiparas who delivered vaginally in our hospital from July 2021 to January 2022 were selected in the study and randomly divided into two groups with 53 cases in each group：TEAS combined with ultrasound-guided pudendal nerve block（TP group） and pure epidural analgesia（EP group）. Visual Analog Scale（VAS） scores and β-endorphin（β-EP） concentrations were observed at before intervention（T₀），uterine opening to 6.0 cm（T₁） and the fetal head crowned（T₂）. Besides，the duration of labor，1-minute Apgar score of newborns，perineum condition and complications after delivery were compared between the two groups.Results The VAS scores of the two groups of parturients were both obviously decreased since the beginning of analgesia（P<0.01），and the degree of decrease of VAS scores was different at different time points；the VAS score of TP group was higher than that of EP group at T₁，but lower than that of EP group at T₂（P<0.05）；compared with the EP group，the β-endorphin concentration of the TP group increased at T₁ and T₂（P<0.05）；the first stage of active labor and the second stage of labor time of TP group was shorter than that of EP group，and the rate of maternal perineal lateral resection of TP group was significantly lower than that of EP group（P<0.05），without statistically significant difference in the Apgar score and device-assisted rate of newborns between two groups（P>0.05）.Conclusion The analgesic effect of TEAS is not as significant as that of epidural block in the first stage of labor，while TEAS combined with ultrasound-guided pudendal nerve block can reduce labor pain in the whole process of labor to a degree，shorten the labor process and protect the perineum. And there is no adverse effect，especially when parturient are not suitable for intraspinal analgesia，it can be used as a safe and effective multimodal analgesia in clinic.