Analysis The Safety Of Epidural Anesthesia In Childbirth

Background: Every woman endured labor pain in childbirth,the severity of pain,some described as burning pain,some defined that the pain of labor can be equated with twenty bones fractures in one time.Therefore,puerpera often suffers some mental disorders like anxiety,fear,pain,even feeling despair,that can be leading to a series of neuroendocrine responses,such as circulatory failure,acidosis;placental blood flow reduction,fetal distress,neonatal asphyxia etc al.in,ultimately affect the safety of mother and infant [1].With the rapid development of medical progress in domestic and foreign,labor analgesia,commonly known as “painless childbirth”,can significantly reduce the pain of purepera in childbirth,and ease purepera negative mood with no obvious adverse reaction,it has become a crucial research in both modern obstetrics and anesthesiologists.Labor analgesia technology originated in Europe and America,has a history of a hundred years.In the United States,Britain,Canada and other western countries,the rate of labor analgesia can reach more than 85%,the cesarean section rate was lower than 20%.Due to short history of labor analgesia,patient apprehension and lack of anesthesiologist in China,the labor analgesia rate below 1% while the rate of cesarean section is more than 50%[2].With the release of two-child policy,the research and wildly application of labor analgesia still needs to be improved urgently due to the high rate of cesarean section,increased attention needs of purepera,reduce the labor pain,improve maternal labor.Labor analgesia can be divided into non-drug analgesia and drug analgesia.Non-drug analgesia includes doula,Ramaze breathing therapy,acupuncture analgesia,water delivery,delivery ball,the pain relief of non-drug analgesia is limited.drug analgesia includes Nitrous Oxide inhalation analgesia,anesthesia and spinal anesthesia analgesia.Epidural analgesia is the most widely used owed to it's less complications,more safe and effective,no adverse effects on mother and baby [3,4].Objective: Epidural analgesia technique is first choice in labor analgesia,the drugs mainly include local anesthetics(ropivacaine,bupivacaine,lidocaine)and analgesics(sufentanyl,fentanyl)et al.High concentration and dose of ropivacaine exist no difference in motor and sensory nerve blocking.While small dose and lower concentration of ropicacaine can efficiently block the sensory nerve and has a mild effect on motor nerve.Lidocaine is easy to drug resistance and bupivacaine cardiotoxicity is relatively high,Therefore,small dose and lower concentration of ropicacaine is more suitable for epidural anesthesia in labor analgesia.It has the characteristics of motor and sensory block separation,sensory nerve,motor nerve of mild,so the application in epidural anesthesia analgesia.At the same time lidocaine quickly resistant to bupivacaine cardiotoxicity is relatively high,that of ropivacaine for labor analgesia is safe and effective.In the use of analgesics,sufentanyl has advantages like stable hemodynamics,wild safety range,effective analgesic,rapid onset.So the combined of low dose of ropivacaine and sufentantyl is wildly used in epidural analgesia,it can analgesic effectively with relatively low side effects.In this study,we use the combination of 0.0894% ropivacaine(0.0894%)and sufentanyl(0.5ug/ml)in epidural analgesia,and observed there is no adverse effects on mother and infant,cause its safe and effective,the dose we used can provide a reference in clinical use.Methods: We chose 200 volunteers from 2016.4-2016.08 in Wuhu Second People's Hospital with obstetric delivery,taboo obstetrics and other relative diseases patients are excluded,according to the different intervention methods we divide the patients into two groups,the observation group(100)and the control group(100).The observation group use epidural labor analgesia with 0.0894% ropivacaine and 0.5ug/ml sufentanyl,the control group are natural childbirth.We use VAS(Visual Analogue Scale)to criteria the puerpera pain level and Bromage score to degree the motor nerve block,other observe factors such as labor time of first stage,second,third stage,the frequency use of oxytocin,2 hours postpartum hemorrhage,neonatal asphyxia,cesarean section rate,adverse the reaction and complications of purepera.Results: The pain of observe group is much slight than the control group,the VAS score was significantly decreased compared to the control group(P<0.05),the frequency use of oxytocin(P<0.05),labor time of first stage,second,third stage,,neonatal asphyxia,cesarean section rate,adverse the reaction and complications of purepera(P>0.05),adverse reactions and complications of the two groups such as skin itching,nausea and vomiting,hypotension,urinary retention,perineal edema have no significant difference(P>0.05);motor nerve block analgesia group slightly,Bromage score significant differences between the two groups(P>0.05).Conclusion: The use ropivacaine and sufentanil for epidural anesthesia,the effect of analgesic is sufficient and does not affect the progress of labor,furthermore,there is no adverse effects on mother and infant.This technology is safe and reliable,worthy of clinical use.