Influences of Different Timing of Epidural Analgesia in Latent Phase of Labor on Progress of Labor and Incidence of Cesarean Section

Objective To investigate the optimal timing for epidural analgesia in latent phase of labor,and to observe its influence on labor progress and delivery mode.Methods A total of 160uniparas who voluntarily requested labor analgesia were randomly divided into group B and group C,with 80uniparas in each group.In addition,80uniparas who did not want to receive labor analgesia were selected as the controls(group A).Uniparas in group A were given conventional obstetric management.In group B and C,epidural analgesia was initiated when the cervix was dilated1and 2cm,respectively.The puncture was performed at L2—3.The mixed liquor of 0.085%ropivacaine and 0.5μg·mL-1 sufentanil was administered via the patient controlled epidural analgesia pump(background infusion 10mL·hour,bonus 5mL,lockout time 30minutes).The analgesia was stopped when the cervix was dilated 8cm.Visual analogue scale(VAS)score,labor progress,delivery mode,neonatal Apgar score,postpartum hemorrhage,oxytocin use and maternal satisfaction were record in all three groups.Results Compared with group A,VAS score at 3,8and10cm cervical dilation,duration of the first stage of labor and incidence of cesarean section significantly decreased in group B and group C(all P0.05).Compared with group B,maternal satisfaction decreased in group A but increased in group C(all P0.05).There were no significant differences in neonatal Apgar score at 5minutes after birth,instrumental delivery rate,postpartum hemorrhage and oxytocin use among the three groups(all P0.05).Conclusion The implementation of epidural analgesia at 1or 2cm cervical dilation can shorten the duration of the first stage of labor and reduced the incidence of cesarean section.There were no significant differences in labor progress and delivery mode between uniparas receiving epidural analgesia at 1cm cervical dilation and uniparas receiving epidural analgesia at 2cm cervical dilation.However,uniparas receiving epidural analgesia at 1cm cervical dilation have higher satisfaction than uniparas receiving epidural analgesia at 2cm cervical dilation.