ObjectiveTo explore the effect of different timing of epidural analgesia on labour analgesia after combined spinal-epidural block in parturient.

MethodsOne hundred and sixty cases of full-term primipara were selected, and treated with combined spinal-epidural block when the uterine orifice was opened to 2-3 cm.The parturients were divided into 3 min group, 30 min group, 60 min group and 90 min group(40 cases in each group) by random number table method, which received continuous epidural administration at 3 min, 30 min, 60 min and 90 min after combined spinal epidural block, respectively.The labour duration, neonatal Apgar score, umbilical artery blood gas analysis, times of using patient-controlled analgesia(PCA), use rate of oxytocin, rescue dose and total dose of ropivacaine and adverse reactions were compared between the two groups.

ResultsThe degree of motor nerve block in four groups was grade 0.There were no significant differences in systolic blood pressure, diastolic blood pressure and heart rate between the four groups before analgesia, 30 min after analgesia, 2 h after analgesia, 4 h after analgesia and when uterine orifice being fully opened(P>0.05).There were no significant differences in labour duration, neonatal Apgar score, use rate of oxytocin, use times of PCA, umbilical artery pH, base excess, partial pressure of xygen and partial pressure of carbon dioxide among the four groups(P>0.05).The times of using PCA in 60 min group and 90 min group was higher than that in 3 min group and 30 min group(P < 0.05).The rescue dose and total dose of ropivacaine in 60 min group and 90 min group were higher than those in 3 min group and 30 min group(P < 0.05).There was no significant difference in the incidence of adverse reactions among the four groups(P>0.05).

ConclusionsEpidural analgesia within 30 min after combined spinal-epidural block can reduce the times of using PCA and dosage of ropivacaine.