Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Nov 19, 2023; 13(11): 838-847
Published online Nov 19, 2023. doi: 10.5498/wjp.v13.i11.838
Effects of combined spinal-epidural anesthesia on anxiety, labor analgesia and motor blocks in women during natural delivery
Ling Cai, Jiao-Jiao Jiang, Ting-Ting Wang, Shuang Cao
Ling Cai, Jiao-Jiao Jiang, Ting-Ting Wang, Shuang Cao, Department of Anesthesiology, Shanghai Changning Maternity & Infant Health Hospital, Shanghai 200050, China
Author contributions: Cai L and Cao S initiated the project and designed the experiment; Jiang JJ conducted clinical data collection; Cai L and Jiang JJ performed postoperative follow-up and recorded data; Wang TT conducted a number of collation and statistical analysis; Cai L wrote the original manuscript; Cao S revised the paper; and all authors have read and approved the final manuscript.
Supported by Changning District Health Commission Medical Key (Characteristic) Specialized Program, No. 20192003.
Institutional review board statement: This study was approved by the Ethics Committee of Shanghai Changning Maternity & Infant Health Hospital.
Informed consent statement: The informed consent was waived by the Ethics Committee.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Shuang Cao, MM, Department of Anesthesiology, Shanghai Changning Maternity & Infant Health Hospital, Jiangsu Road, No. 786 Yuyuan Road, Changning District, Shanghai 200050, China.
Received: July 18, 2023
Peer-review started: July 18, 2023
First decision: August 4, 2023
Revised: August 28, 2023
Accepted: September 22, 2023
Article in press: September 22, 2023
Published online: November 19, 2023

The background of this study was analgesia in natural delivery. The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor, and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases.


To study the effects of combined spinal-epidural anesthesia on anxiety, labor analgesia, and motor blocks in parturients during natural delivery.


A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included; a random number table approach was employed to divide the women into a control group and a joint group, with each group consisting of 60 women. The control group was given epidural anesthesia, while the joint group was given combined spinal-epidural anesthesia. The visual analog scale (VAS) was used to evaluate the degree of maternal pain. Comparisons were made between the two groups’ conditions of childbirth and the duration of labor. Apgar scores were used to evaluate the status of the newborns at birth; Self-rating Anxiety Scale (SAS) and General Self-Efficacy Scale (GSES) scores, umbilical artery blood gas analysis indices and stress indices were compared between the two groups; and the frequencies of motor block and postpartum complications were analyzed.


In comparison to the control group, in the joint group, the VAS scores for the first, second, and third stages of labor were lower (P < 0.05). The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group (P < 0.05). No significant differences were observed in the Apgar score, the duration of the first stage of labor, or the total duration of labor between the two groups (P > 0.05). The second and third stages of labor in the joint group were shorter than those in the control group (P < 0.05). When compared to the control group, the postpartum SAS score of the joint group was lower, while the GSES score was greater (P < 0.05). Between the control group and the joint group, the differences observed in pH, arterial carbon dioxide partial pressure, arterial oxygen partial pressure, or arterial hydrogen ion concentration were not significant (P > 0.05). Nitric oxide, cortisol, and adrenaline levels were lower in the joint group than in the control group (P < 0.05). There were no substantial differences in Bromage grade or rate of complications between the two groups (P > 0.05).


For parturients during natural delivery, combined spinal-epidural anesthesia can reduce anxiety, provide labor analgesia, shorten labor time, and reduce postoperative stress levels but did not result in a motor block.

Keywords: Combined spinal-epidural anesthesia, Natural delivery, Anxiety level, Labor analgesia, Motor block

Core Tip: The pain of parturients in natural delivery is serious. Spinal anesthesia and epidural analgesia are widely used, but the analgesia effect is not good, and the nerve block effect of lumbar epidural anesthesia is better. The objective of this study was to compare the effects of combined epidural and lumbar anesthesia on labor analgesia and movement block.