Comparison of the application of combined spinal epidural anesthesia and continuous epidural anesthesia in analgesia of preclinical labor
ZHANG Fujie１ ＸIA Junlong2 MENG Fanhao1
1.Department of Anesthesiology, Hebei Petroleum Central Hospital, Hebei Province, Langfang 065000, China;
2.Department of Anesthesiology, Ruihe Obstetrics and Gynecology Hospital, Hebei Province, Langfang 065000, China
Abstract：Objective To compare the effects of the two methods of intraspinal block anesthesia on puerperal delivery analgesia on puerperal delivery outcome, delivery process and newborn. Methods A total of 240 eligible pregnant first-time mothers in Hebei Petroleum Central Hospital from June 2017 to July 2018 were selected as the study object. According to the random number table method, they were divided into group A (continuous epidural block and analgesia, 80 cases), group B (combined lumbar stiffness block and analgesia, 80 cases), and group C (no labor analgesia). Puerpera in group A were given continuous epidural block anesthesia when the uterine opening was 1-2 cm, and 0.1% Ropivacaine hydrochloride was given 8 mL. After 30 minutes, the epidural catheter was connected with the automatic electronic analgesic pump. Puerpera in group B were treated with lumbar hard combined block anesthesia when the uterine opening was 1-2 cm, followed by subarachnoid injection of 0.1% Ropivacaine 3 mg. After 30 minutes, the epidural catheter was connected with the automatic electronic pump, and the control group C was in normal delivery. The time of onset of analgesia and patient satisfaction of group A and B were observed respectively. The duration of labor, rate of forceps, Apgar score, use of oxytocin, rate of cesarean section, and side effects were recorded in each group. Results Compared with group A, group B had faster onset time of analgesia and higher patient satisfaction (P < 0.05). The utilization rate of oxytocin in group A and B was significantly higher than that in group C (P < 0.05). Compared with group C, cesarean section rate was significantly lower in group A and B (P < 0.05), the first stage of labor was significantly shortened (P < 0.05). There was no statistically significant difference in forceps utilization rate and neonatal 5 min Apgar score among three groups (P > 0.05); compared with group C, the incidence of maternal side effects, such as nausea, vomiting, respiratory depression, itching, was lower in group A and B, the differences were statistically significant (P < 0.05). Conclusion Combined lumbar epidural anesthesia is safe and effective in the analgesia of preclinical labor, which can provide better delivery experience and is worthy of clinical promotion.
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2019, Vol. 16 
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