| Labor pain causes various degree hurts to mothers and neonates. Anesthetizer and Obstetrician have been making efforts to produce a conscious, safe, painless labor progress for parturients. There have been several kinds of methord for labor analgesia recent years. The best and popular is epidural labor analgesia. The new local anesthetic ropivacaine is more suitable in epidural labor. Analgesin for its high analgesic efficacy and less motor blocked. The aim of this study was toselect the better concentration of ropivacaine in epidural labor analgesia. METHODS: Ninety healthy term primigravid parturients were divided randomly into three groups: Group R(n=30) patients received epidural infusion of 0.2% ropivacaine 10ml/h. Group RF(n=30) patients received epidural infusion of 0.1% ropivacaine with 3 murog/ml fentangl 10ml/h. Group C (n=30) patients received Doula labor analgesia. Maternal measured variables included blood pressure, motor blockade, duration of each labor stage, pain Visual Analogue Scale scores(0~10), mode of delivery, Apgar scores and Neurological Adaptive Capacity Scores (NACS) of neonates, gas analysis of umbilical vein blood. Results were expressed as mean s and analyzed using the t test, chi-square, level of significance: a =0.05.RESULTS:1. Analgesic efficacy: VAS scores(at the 30th min after epidural insertion): Group R 1.75 + 0.62; Group RF 2 + 0.5; Group C 8.3 + 1.33. The VAS scores were significantly lower after epidural analgesia ingroup R and group RF.2. Duration of labor and type of delivery.The first stage of labor (from the time of epidural insertion to complete cervical dilatation) Group R (193.8+47.3) min; Group RF (205.8 49.2) min; Group C (256.7+46.7) min. The first stages of Labor in group R and group RF were shorter than that in group C. The difference was statistically significant. The second stage of labor: Group R (85.7 + 39.3) min; Group RF (58.3 + 38.1) min; Group C (57.5 + 34.4) min. Group R was longer than group RF and group C, the difference was statistically significant. The rates of cesarean setions and instrumental deliveries in the three groups were not statistically significant differences.3. The neonates outcome during labor epidural. Analgesia: Apgar scores at 1 min and 5 min were not statistically significant differences in the three groups. NACS at 15th min, 2th hour and 24 th hour, the cases of high score ( 35 score) in the three groups were not statistically significant difference. The blood gas of the umbilical veinblood were all in normal range and had no snificant differences in the three groups.4. Level of motor block: Observe the motor block of group R and group RF at the 30th min after epidural insertion. 24 (80%) parturients in group R couldn't walk as usual. Parturients in group RF could walk as usual, but walking was not encouraged. There were not side effects of labor apidural analgesia in the two group.CONCLUSIONS:1. Epidural infusion of 0.2% ropivacaine or 0.1 % ropivacaine with 3 microg 1 ml fentanyl all provided effective analgesia during labor.2. Epcdural labor analgesia can shorten the duration of the first stage of labor. 0.2% ropivacaine prolongs the second stage of labor. Epidural analgesia labor do not increase the rate of cesarean section.3. Neonatal outcome is unaffected by epidural ropivacaine or epidural ropivacaine with fentangl.4. Epidural infusion of 0.1% ropivacaine with 3 microg/mlfentangl can provid effective analgesia during labor and has less potency of motor block. It is a suitable concentration in labor epidural analgesia.5. Epidural infusion low concentration ropivacaine and fentanyl has no late anesthesia effect and side effect to mothers and neonates.
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