Study on the influence of the duration of epidural labor analgesia on the effect of epidural anesthesia during transition to cesarean section
Objective To explore the effect of the duration of epidural labor analgesia on the effect of epidural anesthesia during intrapartum cesarean section.Methods A prospective cohort study was conducted to collect and analyze the clinical data of women who were transferred to cesarean section after epidural labor analgesia in the delivery room of the Maternal and Child Health Hospital of Xinjiang Uygur Autonomous Re-gion from January 2020 to June 2022.According to the implementation time of labor analgesia the cut-off val-ue of 8 hours as the cut-off value,＜8 hours as the short-term group,＞8 hours as the long-term group.All of them were given drugs through epidural catheter inserted during labor analgesia during the transfer to cesare-an section.Routine first give 3 mL of 1.5％lidocaine as the experimental dose.After the onset of effect,10-15 mL of 1％lidocaine and 0.75％ropivacaine mixture was given for epidural anesthesia,and compare the effects and failure rate of epidural anesthesia between the two groups.Results A total of 56 parturients were included,including 26 in the short-term group and 30 in the long-term group.Five cases of epidural anesthesia failure in the long-term group.The failure rate of long-term group was significantly higher than that in the short-term group(16.7％vs.0),and the dosage of delivery analgesic solution of other parturients in the short-term group was significantly less than that in the long-term group[(45.22±5.35)mL vs.(80.15± 10.50)mL],the differences were statistically significant(P＜0.05).There were no significant differences in the total amount of local anesthetic used in cesarean section in the two groups[(15.18±2.52)mL vs.(14.38±1.05)mL],the time from medication dose to skin incision[(22.05±8.42)min vs.(23.45±6.87)min].the operation time[(88.75±21.72)min vs.(85.10±13.22)min]between the two groups.There were no maternal and neonatal adverse events in the two groups.the sensory block level after anesthesia in the long-term group[T9(T4),T10)vs.T6(T4,T7)]and the grade of motor block[1(0,1)gradle class vs.2(1,3)gradle class]were lower than those in short-term group.Compared with the short-term group,the long-term group had significantly higher complaints of discomfort during muscle separation after skin incision(24.0％vs.11.5％)and abdominal exploration after uterine suture(84.0％vs.61.5％),the differences were statistically significant(P＜0.05).Conclusion For the parturients who receive epidural labor analgesia in the delivery room,the longer the duration of labor analgesia,it will not only reduce the effect of epidural anesthesia,but also in-crease the risk of anesthesia failure and the probability of re-puncture during the subsequent cesarean section.
万方数据
维普
