Effects of combined spinal-epidural anesthesia on anxiety,labor analgesia and motor blocks in women during natural delivery

BACKGROUND The background of this study was analgesia in natural delivery.The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor,and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases.AIM To study the effects of combined spinal-epidural anesthesia on anxiety,labor analgesia,and motor blocks in parturients during natural delivery.METHODS A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included;a random number table approach was employed to divide the women into a control group and a joint group,with each group consisting of 60 women.The control group was given epidural anesthesia,while the joint group was given combined spinal-epidural anesthesia.The visual analog scale(VAS)was used to evaluate the degree of maternal pain.Comparisons were made between the two groups’conditions of childbirth and the duration of labor.Apgar scores were used to evaluate the status of the newborns at birth;Self-rating Anxiety Scale(SAS)and General Self-Efficacy Scale(GSES)scores,umbilical artery blood gas analysis indices and stress indices were compared between the two groups;and the frequencies of motor block and postpartum complications were analyzed.RESULTS In comparison to the control group,in the joint group,the VAS scores for the first,second,and third stages of labor were lower(P<0.05).The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group(P<0.05).No significant differences were observed in the Apgar score,the duration of the first stage of labor,or the total duration of labor between the two groups(P>0.05).The second and third stages of labor in the joint group were shorter than those in the control group(P<0.05).When compared to the control group,the postpartum SAS score of the joint group was lower,while the GSES score was greater(P<0.05).Between the control group and the joint group,the differences observed in pH,arterial carbon dioxide partial pressure,arterial oxygen partial pressure,or arterial hydrogen ion concentration were not significant(P>0.05).Nitric oxide,cortisol,and adrenaline levels were lower in the joint group than in the control group(P<0.05).There were no substantial differences in Bromage grade or rate of complications between the two groups(P>0.05).CONCLUSION For parturients during natural delivery,combined spinal-epidural anesthesia can reduce anxiety,provide labor analgesia,shorten labor time,and reduce postoperative stress levels but did not result in a motor block.

Comparison on the Perinatal Complications for Newborns between by IVF-ET and Natural Delivery

This study was conducted to compare the perinatal complications for newborns by In vitro fertilization with embryo transfer(IVF-ET)and natural delivery.Respectively 50 cases of the IVF-ET and 50 cases of the natural delivery were selected from Hospital of Chengde Medical University as research subjects.All the recruited cases were selected with the newborns from April,2021 to April,2022.Defining the IVF-ET as the test group,while the natural delivery as the control group to compare and analyze the perinatal situations and the incidences of complications in both the groups.This study showed that the incidences of pregnancy-induced hypertension,diabetes,multiple pregnancy,premature delivery,and cesarean section in the test group were significantly(p<0.05)higher,than the control group.In addition,the incidences of neonatal respiratory distress syndrome(NRDS)and hyperbilirubinemia of newborns in the test group were statistical(p<0.05)higher,compared to the control group.In contrast,there are no statistically significant differences in terms of hypoglycemia,pneumonia,and neonatal asphyxia incidences between the two groups(p>0.05).Interestingly,there is a significant difference(p<0.05)in the incidences of neonatal cardiac anomalies in both groups,however,no significant differences(p>0.05)were observed in terms of birth defects including hypospadias,the cleft lip and palate,polydactyly,anal atresia,and esophageal atresia in both the groups.In summary,the test tube babies of IVF-ET are more susceptible to complications in their perinatal stage compared with natural delivery newborns,therefore,during the clinical development physicians should strengthen clinical attention and take proactive healthcare management,in order to maintain the health and life of the newborns.