Clinical study of spinal and epidural block combined with nitrous oxide inhalation for labor analgesia.

Objective To study the pain relief in delivery and the influence on maternal and infants by using spinal and epidural block combined with nitrous oxide inhalation for labor analgesia.Methods:Six hundred ASA I-II maternal which voluntarily accept labor analgesia were randomly divided into three groups,each with two hundred cases.GROUP Ⅰ:Labor analgesia by spinal-epidural block and patient controlled epidural analgesia using ropivacaine mixed with fentanyl.GROUP Ⅱ:Labor analgesia by nitrous oxide inhalation.GROUP Ⅲ:Labor analgesia by spinal-epidural block and patient controlled epidural analgesia using ropivacaine mixed with fentanyl combined with nitrous oxide inhalation.Observed the analgesia score,duration of labor,blood oxygen saturation of maternal,way of delivery and neonatal asphyxia of each case during labor analgesia.Results:Comparing GROUP Ⅲ with GROUP Ⅰ or GROUP Ⅱ,there was no statistically difference between the patients'age,weight、and gestational age(p 0.10);the time of the first active phase of labor and the second stage was significant difference(p0.05),the time of GROUP Ⅲ was shorter than that of GROUP Ⅰ;the difference of analgesic effect was statistically significant(p0.05),analgesia of GROUP Ⅲ was better than that of GROUP Ⅱ;the difference of neonatal Apgar score in 1 minute was statistically significant(p0.05),the Apgar score of GROUP Ⅲ was bigger than that of GROUP Ⅰ,but the difference of neonatal Apgar score in 5 minutes was not statistically significant(p0.05);and there was no significant difference between the patients'blood oxygen saturation and the way of delivery.Conclusions:The labor analgesia by spinal epidural block and patient controlled epidural analgesia using ropivacaine mixed with fentanyl combined with nitrous oxide inhalation was obviously better than that only by spinal-epidural block and patient controlled epidural analgesia using ropivacaine mixed with fentanyl or by nitrous oxide inhalation.It's the optimal ideal for labor analgesia with better pain relief,less effect on duration of labor and neonatal Apgar score.