The application of combined spinal-epidural analgesia and patient-control epidural analgesia in painless labor

Objective:To study the effects of combined spinalepidural analgesia(CSEA) and patient-control epidural analgesia on mode of delivery.Methods:Sixty ASA Ⅰ～Ⅱ full term primigravidain active labor who had a single fetus with vertex presentation and were expected to have a vaginal delivery were randomly divided into 2 groups:analgesia group(A) received CSEA+PCEA with ropivacaine and sufentanyl(n=30),Control group(B) received no analgesia(n=30);In group A CSEA was performed at L2～3 at 2～3 cm cervical dilation.0.2% sufentanyl 3～5 μg were injected intrathecally.A catheter was then advanced 4 cm into epidural space cephalad for PCEA with a mixture of 0.1% ropivacaine with sufentanyl 1.5 μg/mL(background infusion 4 mL/h,demand bolus 4 mL with a 15 min lockout interval).In group B patients was normal delivery with no analgesia.The intensity of pain,the retardant situation of nervus,the progress of labor,the way of delivery and the score of Apgar after birth was observed and recorded.Results:Statistical difference was found between the two groups in the effect of analgesia(P0.01).The duration of active phase in the first stage and the second stage in the study group were significantly longer than that of control group(P0.05).The difference of Apgar score of newborn after 1,5 min has no statistically significant.Conclusion:CSEA+PCEA has positive effect on labor analgesia and result in no motor block and little adverse feedbacks.Although it has adverse effect on labor progress,delivery consequence can not be affected apparently.