Effect of epidural pre-injection of low-dose chloroprocaine on analgesia during second parturition

Abstract

Purpose: To investigate the anesthetic effect of epidural pre-catheterization with low-concentration chloroprocaine during the second parturition. Methods: 180 second-trimester primiparas undergoing epidural analgesia in Maanshan Maternal and Child Health Care Hospital,  Ma'anshan, China were randomly divided into 3 groups, viz, precatheterization with chloroprocaine (group A), routine chloroprocaine  (group B), and routine ropivacaine (group C), with 60 patients per group. The time of onset of analgesia, visual analogue scale (VAS) scores, modified Bromage score (MBS) scores, neonatal 1- and 5-min Apgar scores, oxytocin use, number of cesarean sections, volume of  postpartum hemorrhage, and incidence of anesthesia-related complications were compared among the three groups. Results: Onset time of anesthesia was significantly shorter in women in groups A and B than in group C (p < 0.05). The VAS scores at 5  and 15 min after analgesia were lower in groups A and B than in group C (p < 0.05). There were no significant differences in VAS scores  among the three groups from 30 min after analgesia to the end of the first stage of labor (p > 0.05). There were also no significant differences in MBS scores, neonatal Apgar scores, oxytocin use, number of cesarean sections, volume of postpartum hemorrhage, and  incidence of adverse reactions among the three groups (p > 0.05). Conclusion: Individualized mode of analgesia involving the  administration of low-concentration chloroprocaine to primiparas using an epidural catheter has timely onset of analgesia, good efficacy, high safety, rapid metabolism, and minimal adverse reactions. Further studies involving multiple centers and long-term follow-up are  necessary.