Abstract：
Generally, combined spinal-epidural anesthesia (CSEA) for labor analgesia is performed in the lateral or sitting position; however, only few studies have investigated the effect of maternal position on labor analgesia induction. We aimed to retrospectively assess the influence of maternal position on induction time and complications.
We retrospectively analyzed anesthetic and medical records regarding labor analgesia in 201 parturients treated between January 2019 and November 2019. Patients were classified into 2 groups based on their position (sitting or lateral) during induction. The primary outcome was the time required for CSEA induction. We compared 2 groups on the primary outcome and the occurrences of other complications during CSEA induction using hyperbaric bupivacaine. Moreover, we performed multiple linear regression analysis to identify independent factors associated with induction time.
There was no significant between-group difference in the time required for induction. Multiple linear regression analysis revealed an independent association of the distance from the skin to the epidural space with the time required for induction. The lateral group had a significantly higher incidence of paresthesia than the sitting group (P = 0.028). The lateral group had a significantly higher ephedrine requirement (P < 0.001) than the sitting group.
Maternal position was not associated with the time required for CSEA induction. However, the sitting group had a lower paresthesia occurrence and ephedrine requirement than the lateral group. Other technical complications were not associated with maternal position during CSEA induction.
We retrospectively analyzed anesthetic and medical records regarding labor analgesia in 201 parturients treated between January 2019 and November 2019. Patients were classified into 2 groups based on their position (sitting or lateral) during induction. The primary outcome was the time required for CSEA induction. We compared 2 groups on the primary outcome and the occurrences of other complications during CSEA induction using hyperbaric bupivacaine. Moreover, we performed multiple linear regression analysis to identify independent factors associated with induction time.
There was no significant between-group difference in the time required for induction. Multiple linear regression analysis revealed an independent association of the distance from the skin to the epidural space with the time required for induction. The lateral group had a significantly higher incidence of paresthesia than the sitting group (P = 0.028). The lateral group had a significantly higher ephedrine requirement (P < 0.001) than the sitting group.
Maternal position was not associated with the time required for CSEA induction. However, the sitting group had a lower paresthesia occurrence and ephedrine requirement than the lateral group. Other technical complications were not associated with maternal position during CSEA induction.
摘要：
目标：一般来说，腰-硬联合麻醉(CSEA)用于分娩镇痛是在侧卧位或坐位进行;然而,只有少数研究调查了产妇位置对分娩镇痛诱导的影响。我们旨在回顾性评估产妇位置对诱导时间和并发症的影响。
方法：我们回顾性分析了2019年1月至2019年11月期间201例产妇分娩镇痛的麻醉和医疗记录。根据诱导过程中的位置（坐位或侧位）将患者分为2组。主要结果是CSEA诱导所需的时间。我们比较了两组在使用高压布比卡因诱导CSEA期间的主要结局和其他并发症的发生情况。此外，我们进行了多元线性回归分析,以确定与诱导时间相关的独立因素.
结果：诱导所需的时间没有显着差异。多元线性回归分析显示，从皮肤到硬膜外腔的距离与诱导所需时间之间存在独立关联。侧方组感觉异常发生率明显高于坐位组(P=0.028)。外侧组的麻黄碱需求量明显高于坐位组（P<0.001）。
结论：母亲位置与CSEA诱导所需的时间无关。然而,坐组的感觉异常发生率和麻黄碱需求低于外侧组。其他技术并发症与CSEA诱导期间的母体位置无关。
方法：我们回顾性分析了2019年1月至2019年11月期间201例产妇分娩镇痛的麻醉和医疗记录。根据诱导过程中的位置（坐位或侧位）将患者分为2组。主要结果是CSEA诱导所需的时间。我们比较了两组在使用高压布比卡因诱导CSEA期间的主要结局和其他并发症的发生情况。此外，我们进行了多元线性回归分析,以确定与诱导时间相关的独立因素.
结果：诱导所需的时间没有显着差异。多元线性回归分析显示，从皮肤到硬膜外腔的距离与诱导所需时间之间存在独立关联。侧方组感觉异常发生率明显高于坐位组(P=0.028)。外侧组的麻黄碱需求量明显高于坐位组（P<0.001）。
结论：母亲位置与CSEA诱导所需的时间无关。然而,坐组的感觉异常发生率和麻黄碱需求低于外侧组。其他技术并发症与CSEA诱导期间的母体位置无关。
