Abstract
Objective： To explore the optimal anesthetic method of transferring to emergency cesarean section after the failure of labor analgesia. Methods: A retrospective study included 1154 patients who underwent cesarean section in Hubei Maternal and Child Health Hospital from January 2019 to January 2020, of which 586 patients were transferred to cesarean section after labor analgesia, They were divided into two groups according to the method of anesthesia: Epidural labor analgesia / Epidural anesthesia (ELA/EA) group : After the failure of natural labor during labor analgesia, local anesthetics continue to be added to the epidural(n=282);Epidural labor analgesia/Combined spinal and epidural anesthesia(ELA/CSEA) group: Combined spinal-epidural anesthesia was performed after spontaneous labor failure during epidural labor analgesia(n=304); Combined spinal and epidural anesthesia(CSEA) group: Patients who undergo emergency cesarean section without labor analgesia(n=568). The case data were reviewed and the anesthetic methods, basic vital signs, medication, time, maternal and infant outcome of the three groups were descriptively analyzed. Results: There was a difference in the time of admission to neonatal delivery, the maximum decrease of diastolic blood pressure and the difference of neonatal 1min apgar score between ELA/EA group and ELA/CSEA group. There was a difference in the dosage of spinal anesthesia between ELA/CSEA group and CSEA group. Conclusion: When the obstetrician anesthesiologist fails during labor analgesia and needs to be transferred to cesarean section, they can choose to re-perform combined spinal-epidural anesthesia, which is beneficial to the early outcome of newborns, but the long-term effect on newborns needs to be further studied.
Effects of Epidural Fentanyl on Speed and Quality of Block for Emergency Cesarean Section in Extending Continuous Epidural Labor Analgesia Using Ropivacaine and Fentanyl