Effects of epidural ropivacaine and sufentanil during latent phase of labor in nulliparous women

Objective To evaluate the efficacy of PCEA with ropivacaine and sufentanil in nulliparous women presenting in latent versus active phase of spontaneous labor. Methods One hundred and twenty nulliparous ASA physical status Ⅰ or Ⅱ women at 36 week of gestation who requested labor analgesia were assigned to one of two groups according to cervical dilation (n = 60 each): latent group (cervical dilation 3 cm) and active group (cervical dilation3 cm) . Both groups received a loading dose of 10-15 ml of PECA solution of 0.1% (latent group) or 0.15% ropivacaine (active group) and sufentanil 0.5 μg ·ml-1 . The PCEA pump was programmed to deliver a bolus dose of 6 ml of PCEA solution of 0.1 % ropivacaine and sufentanil 0.5 μg ·ml-1 with a lockout interval of 20 min in latent group or 15 min in active group. The intensity of pain was evaluated using VAS. Motor block was assessed using Bromage scale. The maternal vital signs, the side effects and the Apgar score of the newborn were also recorded. Results The two groups were comparable in regard to age, height, body weight and weeks of gestation. VAS scores (0 = no pain, 10 = worst pain) were higher in active group than in latent group before epidural analgesia and were significantly reduced after loading dose in both groups. Parturients in active group had lower VAS scores at 20 and 30 min after epidural loading dose than those in latent group. More parturients in active group had feeling of lower limb numbness. Oxytocin consumption was significantly higher before and during analgesia in latent group. There were no significant differences in the length of labor, incidence of Cesarean section or instrumental delivery and Apgar scores between the two groups. Patient satisfaction was equally high in both groups.Conclusion PCEA with 0.1% ropivacaine plus sufentanil 0.5 μg·ml-1 provides excellent analgesia with minimal adverse effect for patients in latent phase of labor.