Application Of Combined Spinal-Epidural Anesthesia In Labor Analgesia

Objective: In recent years,with the popularization of labor analgesia,how to improve a parturient the comfortable sensation and satisfaction levels in delivery process has become an important research topic.The purpose of this study is to investigate the safety and superiority of Combined SpinalEpidural Anesthesia in labor analgesia,so that parturient can obtain a comfortable and happy delivery environment.Methods: This study included 140 pregnant women without obstetric complications who were 20-35 years old,ASA Ⅰ-Ⅱ.Subjects were randomly divided into three groups of 70 each named as group EA and group CSEA.Epidural analgesia was applied to group EA,combined spinal-epidural anesthesia was applied to group CSEA.The time of labor,VAS score,muscle strength of lower limbs(Modified Bromage Score),Apgar score of neonates and adverse effects were observed and recorded.Results: Five parturients were excluded from the study for changing to cesarean section midway,one hundred and thirty-five parturients were included in the statistics,sixty-seven in group EA and sixty-eight in group CSEA.1.When the orifice of the uterus was opened to 3cm、6cm、8cm and10 cm respectively,the VAS scores of the CSEA group were significantly lower than those of the EA group at each stage,with statistical significance(P<0.05).2.The improved Bromage score was used to compare the lower limb muscle strength of the two analgesia groups during delivery.98.5% of the patients in the CSEA group scored 0,and 89.6% of the patients in the EA group scored 0,which was significantly lower than that in the EA group,with statistical significance(P<0.05).3.The time of labor in the EA group was significantly shorter than that in the EA group,and the difference was statistically significant(P<0.05).4.There was no statistical difference in Apgar score between the two groups(P>0.05).5.Compared with the adverse reactions of the two analgesia groups,the incidence of parturnal fever in the CSEA group(29.4%)was significantly higher than that in the EA group(7.5%),with statistical significance(P<0.05);There was no significant difference in other adverse reactions between the two groups(P>0.05).Conclusion: Among the two commonly methods of labor analgesia,the combined spinal-epidural anesthesia(CSEA)has better analgesic effect than the epidural analgesia(EA),with good safety,can be promoted as a labor analgesia method with wide application prospect.