Occasion of Administration of Combined Spinal Epidural Analgesia and Patient-control Epidural Analgesia on Labor———Latent Stage Analgesia versus Active Stage Analgesia

【Objective】This study was designed to explore whether combined spinal-epidural analgesia(CSEA) and patient-control epidural analgesia(PCEA) has influence on labor progress and adverse events between latent stage analgesia and active stage analgesia.【Methods】 The subjects were divided into two groups: latent stage analgesia group(130 cases) received CSEA+PCEA in latent phase(cervical dilatation was 3 cm),active stage analgesia group(240 cases) received CSEA+PCEA in active phase(cervical dilatation was ≥3 cm).The following indexes were observed: age,gestational weeks,times of pregnancy,duration of labor,mode of delivery,the oxytocin infusion,the quantity of hemorrhage,fetal distress and meconium-stained amniotic fluid,fetal birth weight and Apgar scores(1,5 minutes) and neonatal jaundice.【Results】 The duration of latent phase in the latent stage analgesia group were significantly longer than that of active stage analgesia group [(453 ± 203) min vs(338 ± 182) min,P = 0.000].The duration of active phase in the active stage analgesia group were significantly longer than that of latent stage analgesia group [(229 ± 109) min vs(197 ± 101) min,P = 0.011].No statistical difference was found between the two groups in the duration of the second stage,the third stage,and total stage(P = 0.200,P = 0.222,P = 0.091,respectively).Oxytocin application were more frequent in the latent stage analgesia group.There was no difference in the rate of instrumental delivery or cesarean section between the two groups.There was no difference in the quantity of postpartum hemorrhage between the two groups(P 0.05).There were no significant differences in the rate of fetal distress or neonatal Apgar scorces and neonatal jaundice between the two groups(P 0.05).【Conclusions】 CSEA + PCEA in the latent phase was associated with an increased risk of inhibition of uterine contraction and prolonged latent stage.Application of oxytocin could avoid adverse effect of combined spinal epidural analgesia and patient-control epidural analgesia on labor.