Bolos epidurales intermitentes programados para mantenimiento de la analgesia del trabajo de parto: Estudio observacional, analítico de tipo cohorte

Abstract

Objective: Neuroaxial analgesia is the most effective technique to treat labor pain, however, there are still concerns regarding the undesirable effects. Objective: To evaluate the association between epidural analgesia maintained by programmed intermittent epidural boluses (PEIB) and maternal perinatal complications.  Materials and methods: Observational, analytical study of Cohort type in pregnant women between 18 and 35 years, in labor with cervical dilation of 4 centimeters or more, grouped in two cohorts according to administration or not of epidural analgesia: In pregnant women of Group A, administered bolus epidural analgesia, with maintenance by BEIP with bupivacaine 0.0625% and fentanyl 25 ug in 10cc every 60 minutes; in pregnant women of group B, epidural analgesia was not administered. Results: The duration of the dilation and expulsion period was longer in the group that received epidural analgesia of (532.91 ± 254 minutes) and (429.19 ± 311 minutes) in which they did not receive; the time of the expulsion period was (16.97 ± 16 minutes) and (11.76 ± 10 minutes) in group B, (p <0.05); lower incidence of first degree perineal tears in the group that received analgesia (16.12% VS 25.35%; p = 0.014). No differences were found in the route of completion of labor, APGAR score, need for neonatal resuscitation and admission to Neonatal intensive care unit (NICU). Conclusions: Pregnant women who received epidural analgesia through BEIP had a longer duration of the period of dilation and expulsion, less incidence of perineal tears, without increasing neonatal morbidity.