Influence of combined spinal-epidural anesthesia on course and mode of delivery

Objective To assess analgesic effect of combined spinal-epidural anesthesia(CSEA) in labor.Methods Retrospective analysis was conducted.270 healthy primiparae with full-term and sing-fetus who received CSEA(as CSEA group) and another 384 primiparae who did not receive CSEA(as control group) were compared for duration of labor and mode of delivery,and neonatal Apgar scores.Results Those primiparae in the CSEA group experienced longer active phase in the first stage [(265 ±114)min] and the second stage [(59± 39)min] of labor as compared with the control group[(176 ±110)min,(45 ±32)min].No significant difference was found in the two groups in duration of the third stage of labor [CSEA:(8± 6)min,Control:(9± 6)min].There were significant differences between the two groups in overall duration of labor,instrumental delivery rate(in the CSEA group:17.4%,in the control group:4%).But there were no differences in number of those newborns who had a Apgar score less than 7 at the first and the fifth minutes after birth(3.1% and 3.3%,1.36% and 1.32%).Moreover,there was no significant difference in cesarean section rate between the two groups(in the CSEA group:18.5% and in the control group:21.4%).Conclusion Epidural ropivacaine analgesia during labor prolongs the duration of labor and increases the instrumental delivery rate,but it has no significant negative effects on the newborn.So,management of course of labor after CSEA should not accord with the Friedman partogram in absence of anesthesia.