Objective To investigate the effect of epidural block combined with ultrasound-guided bilateral pudendal nerve block multimodal labor analgesia on the analgesic effect in primiparas undergoing natural childbirth.

Methods A total of 158 primiparas with singleton term pregnancies were enrolled and randomly divided into two groups: the epidural block group (EA group) and the EA combined with ultrasound-guided bilateral pudendal nerve block group (combined group), with 79 cases in each group. Epidural puncture at L_3–4 or L_2–3 was performed when the cervix was dilated to 2–3 cm. After catheter placement, a test dose of 4 mL of 1% lidocaine was administered, followed by the injection of 10 mL of a mixture of 0.08% ropivacaine and 0.5 μg/mL sufentanil after confirming no discomfort, and a pulse pump was connected. In the combined group, bilateral pudendal nerve block was added when the cervix was ≥7 cm. The pump was turned off at the end of the third stage of labor in both groups. The indicators of the second stage of labor, mode of delivery, perineal injury, oxytocin use, and adverse reactions were recorded.

Results The duration of the second stage of labor was shorter in the combined group, and the VAS pain score during labor, total PCA pressions, perineal laceration rate, lateral episiotomy rate, and oxytocin use rate were lower than those in the EA group, while the sensation of defecation and maternal satisfaction rate were higher in the combined group (P ＜ 0.05 to P ＜ 0.01).

Conclusion The multimodal labor analgesia effect of EA combined with ultrasound-guided bilateral pudendal nerve block is superior to that of simple epidural block.