Abstract：
OBJECTIVE: Combined spinal-epidural analgesia (CSEA) is effective but not sufficient for labor pain. This study was conducted to assess the real-time analgesic efficacy, side effects of anesthetic drug dosage, and maternal satisfaction in labor to provide reference for the optimization of labor analgesia.
METHODS: This was a prospective, cohort, single-center study that included 3020 women who received CSEA for labor analgesia. The visual analogue scale (VAS) for labor pain, real-time anesthetic drug dosage, side effects, adverse labor outcomes, factors influencing average drug dosage, and maternal satisfaction with CSEA were assessed.
RESULTS: Overall, the VAS labor pain score was lowest at the first hour after the anesthesia was given. After 4 h for primiparas and 3 h for multiparas, the VAS score was greater than 3 but the anesthetic drug dosage did not reach the maximum allowed dosage at the same time. The average anesthetic drug dosage was positively correlated with fever, urinary retention, uterine atony, prolonged active phase, prolonged second stage, assisted vaginal delivery, and postpartum hemorrhage. The average anesthetic drug dosage was the highest in women ≤ 20 years old, those with a body mass index (BMI) ≥ 24.9 kg/m2, and those with a primary or secondary education level.
CONCLUSIONS: Appropriate age guidance and emphasis on education of labor analgesia, weight management during pregnancy, and real-time anesthetic dosage adjustment during labor based on VAS pain score may have positive effects on the satisfaction of labor analgesia.
BACKGROUND: Clinicaltrials.gov (ChiCTR2100051809).
METHODS: This was a prospective, cohort, single-center study that included 3020 women who received CSEA for labor analgesia. The visual analogue scale (VAS) for labor pain, real-time anesthetic drug dosage, side effects, adverse labor outcomes, factors influencing average drug dosage, and maternal satisfaction with CSEA were assessed.
RESULTS: Overall, the VAS labor pain score was lowest at the first hour after the anesthesia was given. After 4 h for primiparas and 3 h for multiparas, the VAS score was greater than 3 but the anesthetic drug dosage did not reach the maximum allowed dosage at the same time. The average anesthetic drug dosage was positively correlated with fever, urinary retention, uterine atony, prolonged active phase, prolonged second stage, assisted vaginal delivery, and postpartum hemorrhage. The average anesthetic drug dosage was the highest in women ≤ 20 years old, those with a body mass index (BMI) ≥ 24.9 kg/m2, and those with a primary or secondary education level.
CONCLUSIONS: Appropriate age guidance and emphasis on education of labor analgesia, weight management during pregnancy, and real-time anesthetic dosage adjustment during labor based on VAS pain score may have positive effects on the satisfaction of labor analgesia.
BACKGROUND: Clinicaltrials.gov (ChiCTR2100051809).
摘要：
目的：脊髓-硬膜外联合镇痛（CSEA）是有效的，但不足以缓解分娩疼痛。这项研究是为了评估实时镇痛效果，麻醉药物剂量的副作用，为优化分娩镇痛提供参考。
方法：这是一个前瞻性的，队列,单中心研究包括3020名接受CSEA分娩镇痛的女性。分娩疼痛的视觉模拟量表（VAS），实时麻醉药物剂量，副作用,不利的分娩结果，影响平均药物剂量的因素，并评估了产妇对CSEA的满意度。
结果：总体而言，麻醉后第1小时VAS分娩疼痛评分最低.初产妇4小时后，多段产妇3小时后，VAS评分大于3分,但麻醉药物剂量未同时达到最大允许剂量.麻醉药物平均用量与发热呈正相关,尿潴留,子宫收缩乏力,延长活跃期,延长第二阶段，辅助阴道分娩,产后出血。平均麻醉药物用量最高的是≤20岁女性,体重指数（BMI）≥24.9kg/m2的人，以及初等或中等教育水平的人。
结论：适当的年龄指导和重视分娩镇痛教育，怀孕期间的体重管理，基于VAS疼痛评分的产程中实时调整麻醉药用量对分娩镇痛满意度有积极影响。
背景：Clinicaltrials.gov（ChiCTR2100051809）。
方法：这是一个前瞻性的，队列,单中心研究包括3020名接受CSEA分娩镇痛的女性。分娩疼痛的视觉模拟量表（VAS），实时麻醉药物剂量，副作用,不利的分娩结果，影响平均药物剂量的因素，并评估了产妇对CSEA的满意度。
结果：总体而言，麻醉后第1小时VAS分娩疼痛评分最低.初产妇4小时后，多段产妇3小时后，VAS评分大于3分,但麻醉药物剂量未同时达到最大允许剂量.麻醉药物平均用量与发热呈正相关,尿潴留,子宫收缩乏力,延长活跃期,延长第二阶段，辅助阴道分娩,产后出血。平均麻醉药物用量最高的是≤20岁女性,体重指数（BMI）≥24.9kg/m2的人，以及初等或中等教育水平的人。
结论：适当的年龄指导和重视分娩镇痛教育，怀孕期间的体重管理，基于VAS疼痛评分的产程中实时调整麻醉药用量对分娩镇痛满意度有积极影响。
背景：Clinicaltrials.gov（ChiCTR2100051809）。
