Epidural labor analgesia basically meets the above requirements, is easy to implement, has few adverse reactions, and is highly controllable. It is currently the most commonly used in clinical practice.

CSEA and continuous spinal anesthesia have concerns about leakage of cerebrospinal fluid, postoperative headache, and requirement for supine positioning.

Ropivacaine has a long-lasting analgesic effect. It can block the separation of sensory and motor nerves at low concentrations. The drug does not easily pass through the placental barrier and has no effect on the blood perfusion of the uterus and placenta. It is highly safe.

Fentanyl is an opioid receptor agonist with a strong narcotic analgesic effect. It can effectively inhibit pain afferent nerves and block the pain perception below the waist of the parturient. Combined with ropivacaine for analgesia, it can reduce The concentration of local anesthetic drugs reduces the dosage of anesthetics, enhances the analgesic effect, reduces motor blockade, has less inhibition on the central nervous system, is safer, and the administration method is simple and the effect is rapid.

Epidural anesthesia uses a large amount of analgesic, has a slow onset of action, and may block motor nerves, but it lasts long and can achieve continuous analgesia during labor.

In order to make the analgesic advantages of spinal anesthesia and epidural anesthesia complementary, the two are implemented together, that is, CSEA,

Method: During delivery, rapid-acting spinal anesthesia is first used for analgesia, and then continuous epidural anesthesia is used to maintain it.

the difference

CSEA is used for labor analgesia and is especially suitable for parturients whose cervix is ​​dilated more than 5 cm, labor progresses rapidly, and pain is severe.

A microcatheter is inserted through the subarachnoid space and local anesthetics and/or opioids are intermittently injected into the subarachnoid space to achieve continuous subarachnoid space block, which is called continuous spinal anesthesia.

This method has a definite analgesic effect, but requires higher conditions.

Using analgesic measures on the basis of regular uterine contractions can not only help the mother relax and increase the pelvic floor muscles

When the fetal head compresses the cervix, it promotes rapid expansion of the cervix, shortens the labor process, reduces the chance of a mother choosing a cesarean section, increases the natural delivery rate, and effectively improves the outcome of delivery.

Effectively reduces maternal postpartum hemorrhage and improves maternal satisfaction with delivery

Latent period neuraxial anesthesia is more suitable for parturients with severe pain. It does not have motor block and allows the mother to participate in the entire labor process. The mother can not only stay awake, but also eat and drink, and will not affect the mother's uterine contraction and cervical dilation.

The clinical application effect of neuraxial anesthesia and labor analgesia during the latent period (cervical dilation 1~2 cm) is significant, which can effectively improve maternal and infant outcomes and reduce pain scores.

Anesthesia in the active phase can easily affect the delivery outcome of newborns and lead to asphyxia in newborns.

Advantages: Compared with continuous background infusion, PIEB mode has equivalent analgesic effect, but PIEB requires fewer additional drug additions and total drug consumption, and at the same time, maternal satisfaction is higher.

The working principle of the pulse pump is to rapidly release a fixed dose of anesthetic drugs into the epidural space at intervals of the same period of time.

Comparison: Compared with the continuous slow infusion pump, it has the characteristics of interval and high speed. Its infusion rate is much greater than that of the traditional continuous pump. There is no statistically significant difference in the impact of pulse pump on labor compared with traditional continuous epidural infusion. However, pulse pump mode has the advantages of reducing the use of local anesthetics, reducing the risk of explosive pain and improving maternal satisfaction.

Its administration mode adopts the first dose, continuous background infusion volume and patient-controlled volume.