Study on the effect of combined spinal-epidural analgesia on mother and infant during labor

Objective:To study whether combined spinal-epidural analgesia (CSEA) and patient-control epidural analgesia (PCEA) has influence on mothers and infants.Methods:Cases data of 627 healthy nulliparas were retrospectively analyzed, study group (345 cases) accepted CSEA+PCEA and control group (282 cases) without CSEA+PCEA, to compare the labor course, delivery way and the maternal and fetal outcome.Results:After CSEA+PCEA, the VAS score decreased 87.5%±12.5%, there were more amount of oxytocin (41.4% vs 26.6%), more fetal heart rate abnormal (FHR) (36.5% vs 20.6%) and more surgery delivery because of abnormal FHR (26.4% vs 15.6%), more urine retention during labor (27.0% and 10.3%) and more amnion meconium (21.4% and 14.6%) in the study group than those in the control group.The time of active phase of labor and second stage of study group prolonged than that of control group (271.93±127.44 min and 188.08±110.29 min, 57.39±35.52 and 44.84±31.92 min).There were more forceps (18.0% and 11.7%) and cesarean section (24.9% and 12.1%) in the study group.There were no difference between two groups in the time of 3rd stage, the incidence of postpartum hemorrhage, the Apgar score of newborn and postpartum urine retention.Conclusion:CSEA+PCEA has satisfied analgesic effect, but also has some adverse effects on mothers and infants,so it isn't an ideal method of obstetric anesthesia.