The Journal of Practical Medicine >

2023 , Vol. 39 >Issue 19: 2489 - 2494

DOI: https://doi.org/10.3969/j.issn.1006-5725.2023.19.013

Clinical Research

Effects and satisfaction of combined spinal epidural anesthesia at different time points on labor analgesia in primiparous women

  • Minli HUANG ,
  • Zijing ZHANG ,
  • Hongfei DAI ,
  • Jiaxin LI ,
  • Shuzhen WU ,
  • Changping FANG ,
  • Zuen LIN ,
  • Lingling. WU
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  • *.Department of Obstetrics，the Third Affiliated Hospital of Sun Yat?sen University，Guangzhou 510630，China

Received date: 2023-07-17

  Online published: 2023-11-22

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Abstract

Objective To compare the clinical effects of combined spinal epidural anesthesia （CSEA） at different times on the analgesic effect and satisfaction of primipara. Methods 504 primipara were included in this study. According to different degrees of cervical dilatation， the primipara with CSEA were divided into： Group Ⅰ （from labor to cervical dilation < 2 cm， n = 112 cases）， group Ⅱ （2 cm ≤ Cervical dilation < 5 cm， n = 176 cases）， group Ⅲ （cervix dilation ≥ 5 cm， n = 111 cases）， control group （no neuraxial anesthesia for labor analgesia， n = 105 cases）， in order to compare the effect of labor analgesia and satisfaction at different groups. Results The visual analogue scale （VAS） scores for group Ⅰ and group Ⅱ exceeded 3 points after 4 hours of labor analgesia， while the VAS scores for group Ⅲ exceeded 3 points after 3 hours of labor analgesia. The incubation period and the duration of the second stage of labor in group Ⅰ and group Ⅱ were longer than those in group Ⅲ and control group （all P < 0.05）. The incidence of uterine atony in group Ⅰ， group Ⅱ and group Ⅲ were higher than those in the control group （all P < 0.05）. The incidence of fever and urinary retention in group Ⅰ， group Ⅱ and group Ⅲ were higher than that in control group （all P < 0.05）. The satisfaction levels of primiparous women in group Ⅰ and group Ⅱ were significantly higher than those in group Ⅲ and control group （all P > 0.05）. Conclusion CSEA can effectively relieve pain for primiparous women after labor until the cervix is fully dilated. However， 4 hours after CSEA within 5 cm of the cervix， 3 hours after CSEA for cervix dilation larger than 5 cm， the anesthetic dose should be adjusted in time according to the pain score to achieve effective analgesia. It is important to observe and treat side effects related to anesthesia drugs in a timely manner to improve the satisfaction of primiparous women.

Key words： labor analgesia; analgesic timing; maternal and infant outcomes; anesthetic drug doses; satisfaction

Cite this article

Minli HUANG , Zijing ZHANG , Hongfei DAI , Jiaxin LI , Shuzhen WU , Changping FANG , Zuen LIN , Lingling. WU . Effects and satisfaction of combined spinal epidural anesthesia at different time points on labor analgesia in primiparous women[J]. The Journal of Practical Medicine, 2023 , 39(19) : 2489 -2494 . DOI: 10.3969/j.issn.1006-5725.2023.19.013

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