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| The Influence of Timing of Labor Analgesia under Spinal Block Anesthesia on Labor Course and Maternal and Infant Outcomes |
| XIONG Xiaojuan, WAN Jia, ZHANG Chunhua |
| The First Hospital of Nanchang, Nanchang 330008, China |
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Abstract Objective: To study the effect of the timing of labor analgesia under spinal block anesthesia on labor course and maternal and infant outcomes. Method: A total of 120 puerperae in the Obstetrics Department of the First Hospital of Nanchang from June 2021 to May 2022 were selected and randomly divided into four groups by digital table method, with 30 cases in each group. In group A and group B, intraspinal analgesia was performed when cervical dilation ≤3 cm. Group A stopped analgesia after dilation of the cervix; group B continued analgesia after dilation; group C and group D received intraspinal analgesia when the dilation of the cervix was greater than 3 cm. Group C stopped analgesia after dilation; group D continued analgesia after dilation. The duration of labor and maternal and infant outcomes were recorded in each group. Result: There were statistically significant differences in the time spent in the first stage of labor, the second stage of labor and the total stage of labor among the groups (P<0.05). There was no significant difference in the duration of the third stage of labor among the groups (P>0.05). Pairwise comparison between groups: the first stage of labor and total labor time in group A and group B were significantly longer than those in group C and group D; the second stage of labor in group A and group C were significantly shorter than those in group B and group D, the differences were statistically significant (P<0.05). There were no significant difference in the first stage of labor and total labor time between group A and group B, group C and group D (P>0.05). There were no significant differences in the duration of the second stage of labor between group A and group C, group B and group D (P>0.05). The vaginal delivery rates of group C and group D were 93.33% and 93.33%, respectively, which were higher than 70.00% and 70.00% of group A and group B. The use of Oxytocin in group C and group D was 33.33% and 26.67%, respectively, which were lower than 56.67% and 53.33% of group A and group B, the differences were statistically significant (P<0.05). There were no significant differences in vaginal delivery rate and oxytocin usage rate between group B and group A, group D and group C (P>0.05). There were no significant differences in neonatal asphyxia rate, postpartum hemorrhage volume at 2 hours, and neonatal Apgar scores at 1, 5, 10 minutes between the groups (P>0.05). There was no significant difference in the incidence of complications such as lower extremity numbness, urinary retention, pain and itching, fever and nausea among the groups (P>0.05). Conclusion: The whole process of intraspinal labor analgesia is a more appropriate analgesic method when the cervix is ..dilated >3 cm, and it can shorten the labor process, and has little effect on maternal and infant outcomes.
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Received: 09 October 2022
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