Comparison of Ropivacaine Combined With Sufentanil for Epidural Anesthesia and Spinal-epidural Anesthesia in Labor Analgesia

Yanshuang Wang; Mingjun Xu

BMC Anesthesiol. 2020;20(1)

Conclusion

CSEA group in this study achieved better analgesic effect, lower onset time and fewer adverse drug reactions compared with CEA group. Thus, CSEA method with our block method and doses may provide some reference for clinical labor analgesia.

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Acknowledgments
None.

Funding
None.

Availability of data and materials
The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Ethics approval and consent to participate
This study was approved by the institutional ethics committees of the Beijing Obstetrics and Gynecology Hospital and written informed consent was obtained from parturients before labor analgesia.

Consent for publication
Not applicable.

Table 1. Clinical characteristics of subjects (mean ± SD)
	CEA (n = 180)	CSEA (n = 180)	P value
Age, years	26.8 ± 4.2	27.1 ± 3.9	0.483
Height, cm	160.4 ± 4.3	161.3 ± 4.6	0.056
Weight, kg	65.4 ± 16.2	66.3 ± 15.6	0.592
BMI, kg/m²	22.3 ± 3.4	22.2 ± 3.1	0.771
Duration of pregnancy, weeks	38.5 ± 1.3	38.3 ± 1.4	0.161

BMI Body Mass Index. P value of comparison between CSEA and CEA groups

Table 2. Comparison of pain VAS scores at different times in two groups (mean ± SD)
	CEA (n = 180)	CSEA (n = 180)
T₀ (min)	8.32 ± 1.37	8.36 ± 1.35
T₁(min)	3.35 ± 0.64*	3.02 ± 0.67^*#
T₂ (min)	4.22 ± 0.87*	3.84 ± 0.83^*#
T₃ (min)	6.84 ± 1.26*	5.31 ± 1.12^*#

*P < 0.01, vs T₀; ^# P < 0.01, vs CEA group

Table 3. Comparison of labor time in two groups (mean ± SD)
	CEA (n = 180)	CSEA (n = 180)	P value
Onset time (min)	6.32 ± 3.45	3.21 ± 1.42	< 0.001
T₁(min)	524.33 ± 126.46	468.32 ± 114.10	< 0.001
T₂(min)	48.24 ± 10.34	46.09 ± 11.22	0.060
T₃(min)	7.38 ± 0.76	7.24 ± 0.83	0.096
Total labor time (min)	578.29 ± 132.08	512.67 ± 124.38	< 0.001

Table 4. The Apgar scores at 1, 5, and 10 min after birth in two groups (mean ± SD)
	CEA (n = 180)	CSEA (n = 180)	P value
1 min after birth	8.47 ± 0.34	8.41 ± 0.35	0.099
5 min after birth	8.85 ± 0.41	8.83 ± 0.42	0.647
10 min after birth	9.52 ± 0.38	9.48 ± 0.33	0.278

Table 5. Comparison of adverse pregnancy outcomes in two groups (mean ± SD)
	CEA (n = 180)	CSEA (n = 180)	P value
Obstetric apparatus, n (%)	7 (3.89)	8 (4.45)	0.792
Cesarean, n (%)	18 (10.00)	22 (12.22)	0.499
24 h postpartum hemorrhage, n (%)	6 (3.33)	5 (2.78)	0.759
Episiotomy, n (%)	22 (12.22)	16 (8.89)	0.303
Total adverse pregnancy outcomes, n (%)	44 (24.44)	41 (22.78)	0.709

Table 6. Doses of Ropivacaine and Sufentanil in each group. (mean ± SD)
	CEA (n = 180)	CSEA (n = 180)	P value
Ropivacaine	39.88 ± 4.52	38.42 ± 3.16	< 0.001
Sufentanil	19.98 ± 6.66	16.01 ± 5.26	< 0.001

Table 7. Comparison of adverse drug reactions in two groups
	CEA (n = 180)	CSEA (n = 180)	P value
Nausea and vomiting, n (%)	20 (11.11)	8 (4.44)	0.018
Pruritus, n (%)	12 (6.67)	4 (2.22)	0.041
Uroschesis, n (%)	8 (4.44)	4 (2.22)	0.240
Respiratory depression, n (%)	4 (2.22)	2 (1.11)	0.410
Total adverse drug reactions, n (%)	44 (24.44)	18 (10.00)	< 0.001
Subject satisfaction, n (%)	120 (66.67)	150 (83.33)	< 0.001