Abstract:

Objective To compare the clinical efficacy of combined spinal-epidural analgesia (CSEA) and epidural analgesia (EA) with sufentanil and ropivacaine for labor. Methods Sixty nulliparous parturients with cervical dilation of 3 cm were randomly assigned to receive CSEA (CSEA group) or EA (EA group) for labor, with 30 parturients in each group. Another 30 nulliparous parturients without labor analgesia were served as control group. Sufentanil 5 μg was intrathecally injected in every parturient of CSEA group, and was followed by administration of patient controlled analgesia (PCA). For EA group, 0.1％ropivacaine 5 mL in combination with 0.5 μg/mL sufentanil was administered, which was followed by injection of additional 10 mL, and PCA was applied. No analgesia was performed to control group. The analgesic onset time, maximum effect time, satisfaction from parturients, side effects, duration of stages of labor, cesarean section rate, and oxytocin and instrumental delivery were observed. Results The scores of visual analogue scale (VAS) in CSEA group and EA group gradually decreased after intravertebral anesthesia. The analgesic onset time and maximum effect time of CSEA group significantly advanced than EA group. The active periods of CSEA group and EA group were significantly shorter than that in control group (P<0.05). The duration of second stage of labor of EA group was longer than those of CSEA group and control group (P<0.05). There was no significant difference in the duration of the third stage of labor among three groups (P＞0.05). The prevalence of pruritus of CSEA group was higher than those of EA group and control group. The modified Bromage score of EA group was higher than those of CSEA group and control group. There was no significant difference in the cesarean section rate, oxytocin and instrumental delivery rate among three groups (P＞0.05). Conclusion CSEA and EA with sufentanil and ropivacaine are effective and safe for labor. CSEA is more suitable for labor with faster onset, lower consumption of drug and higher rate of satisfaction from parturients．

Key words: combined spinal-epidural analgesia, epidural analgesia, labor analgesia, sufentanil, ropivacaine