A CLINICAL STUDY OF COMBINED SPINAL-EPIDURAL ANALGESIA FOR LABOR PAIN

Objective:To study the effects of combined spinal epidural analgesia (CSEA) on relieving labor pain. Methods:90 primipara were divided into three groups. The control group (C) received no analgesia. The continual epidural analgesia group (CEA) got 0.125% ropivacaine+fentanyl 2μg/ml. The CSEA group received spinal administration with 0.17% bupivacaine 1 ml and 2.5μg fentanyl 1 ml, catheterized through epidural L_(2/3) toward head. The pain intensity,motor function for ambulation,vital signs, fetal heart rate (FHR), birth process, delivery mode and the consumed volumes of oxytocin were recorded. Results:1. Both CEA and CSEA showed good effects on relief of labor pain. The effect of CSEA was better and earlier than CEA ( P 0.05). 2. Active phase of labor stage in CSEA group and CEA group was 142 and 153 minutes, respectively, and was significantly shorter than control group (191 minutes, P 0.05). 3. There were no motor nerve block in any group. 4. The serum cortisol concentrations of labor women were only significantly increased after analgesia than that of before analgesia in control group ( P 0.05). 5. There was no significant difference of serum PRL concentration or the initial time of lactation among three groups ( P 0.05). Conclusion: CSEA and CEA were safe and effective for labor pain relief. But CSEA had superiority than CEA because of its consummate analgesic effect, rapid onset, shortening active phase of labor stage.