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AIM: This study aimed to observe the analgesic effects of Hegu acupoint catgut embedding in a rat model of labor and investigate its influence on biomarkers such as calcitonin gene-related peptide （CGRP） signals at the Hegu acupoint. METHODS: Thirty-six pregnant rats were randomly divided into three groups: control group, Hegu acupuncture group, and Hegu catgut embedding group. Pain threshold changes were assessed using the tail immersion test and paw withdrawal thermal latency at four time points: pre-induction, before the onset of labor, at the onset of labor, and at the mid-stage of labor. Tissue samples from the Hegu acupoint were collected at the mid-stage of labor to detect the expression of CGRP, substance P （SP）, and mast cells using immunofluorescence. The concentrations of ATP and adenosine were measured using ELISA. RESULTS: Before labor induction, there was no significant difference in tail immersion test and paw withdrawal thermal latency among the three groups （P>0. 05）. Before the onset of labor, both the acupuncture and catgut embedding groups exhibited significantly higher tail-flick times and paw withdrawal latencies compared to the control group （P<0. 05）. At labor initiation and mid-labor, the catgut embedding group had significantly higher tail-flick times and paw withdrawal latencies compared to both the control and acupuncture groups （P<0. 05）. During mid-labor, the expression of CGRP, SP, mast cells, ATP, and adenosine concentrations in the catgut embedding group was significantly higher than that in the control and acupuncture groups （P<0. 05）, with co-expression of CGRP, SP, and mast cells observed. CONCLUSION: Hegu acupoint catgut embedding effectively alleviates labor pain, and its mechanism may involve increased local expression of CGRP and SP, promoting mast cell degranulation, and increasing ATP release and its conversion to adenosine. [ABSTRACT FROM AUTHOR]

Objective To compare the clinical effects of combined spinal epidural anesthesia (CSEA) at different times on the analgesic effect and satisfaction of primipara. Methods 504 primipara were included in this study. According to different degrees of cervical dilatation, the primipara with CSEA were divided into： Group Ⅰ (from labor to cervical dilation < 2 cm, n = 112 cases), group Ⅱ (2 cm ≤ Cervical dilation < 5 cm, n = 176 cases), group Ⅲ (cervix dilation ≥ 5 cm, n = 111 cases), control group (no neuraxial anesthesia for labor analgesia, n = 105 cases), in order to compare the effect of labor analgesia and satisfaction at different groups. Results The visual analogue scale (VAS) scores for group Ⅰ and group Ⅱ exceeded 3 points after 4 hours of labor analgesia, while the VAS scores for group Ⅲ exceeded 3 points after 3 hours of labor analgesia. The incubation period and the duration of the second stage of labor in group Ⅰ and group Ⅱ were longer than those in group Ⅲ and control group (all P < 0.05). The incidence of uterine atony in group Ⅰ, group Ⅱ and group Ⅲ were higher than those in the control group (all P < 0.05). The incidence of fever and urinary retention in group Ⅰ, group Ⅱ and group Ⅲ were higher than that in control group (all P < 0.05). The satisfaction levels of primiparous women in group Ⅰ and group Ⅱ were significantly higher than those in group Ⅲ and control group (all P > 0.05). Conclusion CSEA can effectively relieve pain for primiparous women after labor until the cervix is fully dilated. However, 4 hours after CSEA within 5 cm of the cervix, 3 hours after CSEA for cervix dilation larger than 5 cm, the anesthetic dose should be adjusted in time according to the pain score to achieve effective analgesia. It is important to observe and treat side effects related to anesthesia drugs in a timely manner to improve the satisfaction of primiparous women. [ABSTRACT FROM AUTHOR]

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