[Effect of different analgesia on pain relief during labor].
OBJECTIVE
To evaluate the effect of spinal-epidural and epidural anesthesia for pain relief in labor.


METHODS
Totally 6671 cases selected from pregnant women delivered from Aug. 2001 to Oct. 2004 in our hospital were reviewed retrospectively. All cases were divided into three groups, 1482 cases in spinal-epidural group (combined epidural) and 1111 in epidural group (epidural) who received pain relief during labor; 4078 as control group without any pain relief during labor. Delivery method and maternal, fetal complications among three groups were compared.


RESULTS
(1) Delivery methods were significantly different (P < 0.01) among the three groups. The cesarean section (CS) rate in combined epidural was 423 (28.5%); in epidural: 351 (31.6%); and in control, 1847 (45.3%). The forceps delivery rate was 231 (15.6%), 207 (18.9%) and 357 (8.8%) in combined epidural, epidural and control, respectively, demonstrating significant difference (P < 0.01) among three groups. There was significant difference among spinal epidural 828 (55.9%) vs epidural 553 (49.8%) vs control 1874 (46.0%) in the rate of normal delivery. (2) Maternal and fetal complication existed significant difference (P < 0.01) among combined epidural, epidural vs control in the rate of fetal distress 33.7% (499/1482), 29.8% (331/1111), 28.5% (1163/4078), arrested active phase 17.3% (256/1482), 18.1% (201/1111), 8.3% (337/4078), prolonged active phase 1.8% (27/1482), 1.7% (19/1111), 0.8% (34/4078), and prolonged second stage 6.1% (91/1482), 5.4% (60/1111), 3.0% (124/4078). While no difference (P > 0.05) in postpartum hemorrhage and neonatal asphyxia between spinal epidural 4.3% (63/1482) 1.0% (15/1482), epidural 4.1% (45/1111), 0.8% (9/1111), and control 3.9% (159/4078), 1.4% (56/4078).


CONCLUSIONS
Anesthetic pain relief in labor may reduce the CS rate, but increase the rate of forceps delivery. Pain relief is associated with arrested and prolonged active phase, prolonged second stage. However, pain relief in labor does not enhance the rate of postpartum hemorrhage and neonatal asphyxia.
Liu
Yu-jie
YJ
Department of Obstetrics and Gynecology, First Hospital of Peking University, Beijing 100034, China.
Qu
Yuan
Y
Zhang
Xiao-song
XS
Liu
Jun
J
D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D048949:Labor Pain / Q000188:drug therapy*; D007743:Labor, Obstetric / Q000187:drug effects*; D011247:Pregnancy; D012189:Retrospective Studies
D000779:Anesthetics, Local