[Effects of epidural ropivacaine labor analgesia on duration of labor and mode of delivery].

ABSTRACT

OBJECTIVE: To study the effects of ropivacaine on the duration of labor and mode of delivery in the primigravidas using patient-controlled epidural analgesia (PCEA). METHODS: Retrospective analysis was performed. The 190 healthy, full-term, and single-fetus parturient primigravidas who received PCEA with 0.1% ropivacaine + fentanyl (1 microg/ml) were in the epidural analgesia group. Another 222 primigravidas who did not receive PCEA were in the control group. The duration of labor and modes of delivery, and the neonatal Apgar scores in both two groups were recorded and evaluated. RESULTS: Those in the epidural analgesia group experienced a significantly longer first stage [(426 +/- 161) minutes], longer second stage [(54 +/- 27) minutes] and longer full duration of delivery [(489 +/- 166) minutes] than those in the control one [(409 +/- 170) minutes, (364 +/- 167) minutes and (37 +/- 22) minutes]. The rate of using pitocin in the epidural analgesia group (30.2%) was significantly higher than that in the control group (4.1%). The cesarean section rate in epidural analgesia group (20.0%) was lower than that in the control one (28.4%); while the rate of instrumental delivery in the epidural analgesia group (20.0%) was significantly higher than that in the control one (6.3%). In summary, there were significant differences between two groups in the duration of labor, the rate of using pitocin, the rate of instrumental delivery and the rate of cesarean section. But there were no differences found for those newborn who had Apgar scores less than 7 at the point of both one and five minutes (7.9% and 4.5%, 2.6% and 0.5% respectively). CONCLUSION: Epidural ropivacaine labor analgesia lengthens the duration of labor and increases the rate of instrumental delivery, but it has no significant negative effects on the neonates.