Clinical efficacy of combined spinal-epidural anesthesia for painless delivery

Objective: This prospective study was designed to compare the effect of painless childbirth under combined spinal-epidural anesthesia (CSEA) and normal delivery. Methods: We enrolled 86 parturients with full-term singleton pregnancies who were admitted to the Department of Obstetrics and Gynecology in Hengyang Maternal and Child Health Care hospital from June 2018 to December 2019. Among them, 43 parturients with painless delivery were randomly selected into the CSEA group and 43 parturients with normal delivery were put into the non-CSEA group. After anesthesia in the CSEA group, the parturients of both groups at each stage of labor were clinically evaluated in terms of the analgesic efficiency, degree of motor block, delivery mode, labor duration, blood loss at 2 hours and 24 hours after delivery and Apgar scores of the newborns. Results: The analgesic efficiency was significantly higher, and the blood loss at 2 h and 24 h after delivery was much less in the CSEA group than in the non-CSEA group (all P<0.05). Meanwhile, the total length of labor revealed no significant difference between the two groups (P>0.05); however, the duration of the first stage of labor was significantly shorter, while the duration of the second stage of labor was much more prolonged in the CSEA group than in the non-CSEA group (all P<0.05). Otherwise, no significant differences were identified in spontaneous delivery rates and Apgar scores between the two groups (both P>0.05). Conclusion: CSEA can exert an obvious analgesic effect, decrease the rate of cesarean section and assisted delivery, as well as reduce the length of the first stage of labor and postoperative bleeding in the process of delivery, thus greatly alleviating maternal pain and fetal distress and promoting the health of mothers and infants. As a result, the CSEA technique is worthy of promotion and application during delivery.