关键词: 硬膜外分娩镇痛,剖宫产, 硬膜外中转(麻醉), 蛛网膜下腔阻滞(麻醉), 麻醉效果

Abstract: Objective To observe the effects of epidural anesthesia and subarachnoid anesthesia on puerperants and fetus perioperatively undergoing cesarean delivery after epidural labor analgesia. Methods A retrospective cohort study was conducted to select and analyze the relevant clinical data of women who had epidural labor analgesia and were converted to cesarean delivery at Beijing Tiantan Hospital. According to the anesthesia method of cesarean section, the participants were divided into the epidural anesthesia(EA) group and the subarachnoid anesthesia(SA) group. That were aimed to compare the effects of the two anesthesia methods on the mother and fetus perioperatively. Results Compared with women in the epidural anesthesia group, women in the subarachnoid anesthesia group had a better anesthesia outcome,visual analogue scale (VAS) scores, frequency (%)[VAS scores 0-3: 5(25%) vs. 14(70%); VAS scores 4-6: 12(60%) vs. 6(30%); and VAS scores 7-10: 3(15%) vs. 6(30%)], and higher perioperative complication rate. There was nonsignificance difference in perio- perative maternal bleeding, neonatal Apgar score, and neonatal umbilical artery blood gas analysis between the two groups. Conclusions In women with epidural analgesia undergoing cesarean section, the anesthesia effect of subarachnoid anesthesia is better than that of the epidural anesthesia. The anesthesiologist must pay attention to prevent complications in the perioperative period.

Key words: epidural labor analgesia, cesarean delivery, epidural anesthesia, subarachnoid anesthesia, anesthesia effect