Clinical Efficacy of Different Doses of Ropivacaine Combined with Spinal Epidural Anesthesia for Labor Analgesia and Its Impact on Early Lactation Function

ZHAO Li; DENG Enqiong

doi:10.14033/j.cnki.cfmr.2025.35.015

Abstract：Objective:To explore the clinical effect of combined spinal-epidural anesthesia(CSEA)with different doses of ropivacaine for labor analgesia and its influence on early lactation function.Method:64 parturients who delivered at Sinan County People's Hospital from January 2022 to June 2023 were slected as the study objects and divided into a low-dose group and a high-dose group by the odd-even number method,with 32 cases in each group.Both groups underwent CSEA.The high-dose group was given 2 mL of ropivacaine,and the low-dose group was given 1 mL of ropivacaine.The time of the first and second stages of labor between the two groups of parturients.Prolactin(PRL)levels before and 24 hours after delivery,the first postpartum milk production volume,Visual Analogue Scale(VAS)scores before medication,at 10 cm of the cervix,immediately after delivery,and 2 hours after delivery,bromage exercise score 2 hours after delivery,the time of the first defecation and the time of the first anal exhaust after surgery,and the incidence of adverse reactions in the two groups of parturients were compared.Result:Compared with the high-dose group,the time of the first stage of labor,the time of the second stage of labor,the time of the first anal exhaust and the time of the first defecation in the low-dose group were all shortened,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the VAS scores between the two groups before medication,at 10 cm of the cervix,immediately after delivery,and 2 hours after delivery(P>0.05).Compared with the high-dose group,the low-dose group had a lower Bromage exercise score at 2 hours postpartum,a higher PRL level at 24 hours postpartum,and a higher postpartum lactation volume level,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the low-dose group was lower than that in the high-dose group,and the difference was statistically significant(P<0.05).Conclusion:When treating parturients with labor pains,both high and low doses of ropivacaine for combined spinal-epidural anesthesia have good analgesic effects.Compared with the application of high-dose ropivacaine,the application of low-dose ropivacaine for combined spinal-epidural anesthesia can shorten the labor process,accelerate the recovery of postpartum gastrointestinal function,avoid motor nerve block,promote early postpartum lactation and reduce the incidence of adverse reactions.