Effects of different anesthesia methods on labor process and postpartum serum estrogen and progesterone levels in primiparas with painless labor

Liu, JunYan; Shi, ChongLai; Wang, Dan; Cui, XiaoDong; Geng, LiLi; Cui, JingJing; Sun, DongMei; Yin, Zhuo

doi:10.1016/j.clinsp.2024.100442

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Original articles • Clinics 79 • 2024 • https://doi.org/10.1016/j.clinsp.2024.100442 copy

Effects of different anesthesia methods on labor process and postpartum serum estrogen and progesterone levels in primiparas with painless labor

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To look into the effects of different anesthesia methods on the labor process and the expression of serum estrogen and progesterone in primiparas with painless labor.

Methods:

60 primiparas receiving painless labor were selected as the research objects, and they were divided into either a Spinal & Continuous epidural anesthesia group (n = 30) or a continuous epidural anesthesia group (n = 30), anesthesia is administered using the corresponding anesthesia method. The authors compared serum estrogen and progesterone, inflammatory index expression, pain degree and neonatal health status in different periods.

Results:

At T2 and T3, serum P, LH, FSH and E2 levels in the Spinal & Continuous epidural anesthesia group were signally lower than those in the Spinal & Continuous epidural anesthesia group (p < 0.05). Spinal & Continuous epidural anesthesia group harbored faster onset and longer duration of sensory block and motor block than the Continuous epidural anesthesia group (p < 0.05). SAS and SDS scores of the Spinal & Continuous epidural anesthesia group were clearly lower than those of the Continuous epidural anesthesia group (p < 0.05). VAS score and serum TNF-α, IL-6 levels of pregnant women in the Spinal & Continuous epidural anesthesia group were memorably lower than those in the Continuous epidural anesthesia group at T2 and T3 (p < 0.05). The total incidence of postoperative complications in the Spinal & Continuous epidural anesthesia group was distinctively lower than that in the Continuous epidural anesthesia group (p < 0.05).

Conclusion:

Spinal anesthesia combined with continuous epidural anesthesia has a better anesthesia effect in the painless labor of primiparas, which can effectually ameliorate the labor process and the expression of serum estrogen and progesterone.

Keywords:
Anesthesia method; Painless labor; Primipara; Labor process; Serum Estrogen and Progesterone

HIGHLIGHTS

Spinal anesthesia combined with continuous epidural anesthesia has a better anesthesia effect in the painless labor of primiparas.

Spinal anesthesia combined with continuous epidural anesthesia can effectually ameliorate the labor process.

Spinal anesthesia combined with continuous epidural anesthesia attenuates the expression of serum estrogen and progesterone.

Spinal anesthesia combined with continuous epidural anesthesia can be widely employed in clinical practice.

Group	Spinal & Continuous epidural anesthesia (n = 30)	Continuous epidural anesthesia (n = 30)	T	p
Mean age (years)	27.15 ± 2.49	28.24 ± 2.83	0.641	0.407
BMI (kg/m²2 Koyyalamudi V, Sidhu G, Cornett EM, Nguyen V, Labrie-Brown C, Fox CJ, et al. New labor pain treatment options. Curr Pain Headache Rep 2016;20(2):11.)	23.16 ± 1.07	23.49 ± 1.09	0.623	0.418
Pregnancy (d)	278.51 ± 5.48	279.34 ± 5.59	0.583	0.526

Indicator	Time	Spinal & Continuous epidural anesthesia group (n = 30)	Continuous epidural anesthesia group (n = 30)	T	p
P (ng/L)	T₁	765.52 ± 124.17	768.14 ± 125.73	0.673	0.426
	T₂	516.43 ± 72.95	472.85 ± 63.12	6.325	0.001
	T₃	325.61 ± 46.72	281.74 ± 39.35	6.624	0.001
LH (miu/mL)	T₁	814.62 ± 131.53	816.47 ± 128.75	0.572	0.541
	T₂	531.74 ± 84.62	472.38 ± 79.03	6.414	0.001
	T₃	287.82 ± 54.03	213.74 ± 39.46	6.254	0.001
FSH (miu/mL)	T₁	457.23 ± 81.42	459.05 ± 76.84	0.684	0.413
	T₂	362.59 ± 61.59	279.64 ± 48.36	6.752	0.001
	T₃	257.52 ± 35.49	187.69 ± 27.48	6.594	0.001
E2 (pg/L)	T₁	23183.52 ± 1219.63	23189.41 ± 1224.17	0.574	0.513
	T₂	16429.41 ± 974.26	15672.59 ± 913.25	6.532	0.001
	T₃	8464.28 ± 531.07	7824.31 ± 514.19	6.746	0.001

Group		Spinal & Continuous epidural anestesia (n = 30)	Continuous epidural anesthesia (n = 30)	T	p
Sensory block	Onset	8.74 ± 1.62	11.53 ± 2.47	5.732	0.003
Sensory block	Duration	386.92 ± 25.64	342.51 ± 21.63	6.349	0.001
Motor block	Onset	11.34 ± 2.26	14.73 ± 2.61	5.268	0.005
Motor block	Duration	302.64 ± 17.59	283.54 ± 14.41	5.741	0.004

Group		Spinal & Continuous epidural anesthesia (n = 30)	Continuous epidural anesthesia (n = 30)	T	p
Apgar	1 min	8.35 ± 0.31	8.24 ± 0.37	0.673	0.425
	3 min	8.72 ± 0.35	8.75 ± 0.34	0.567	0.513
	5 min	9.42 ± 0.32	9.37 ± 0.30	0.623	0.451
SAS		42.37 ± 4.15	63.58 ± 7.26	6.738	0.001
SDS		40.92 ± 4.26	65.73 ± 7.45	6.417	0.001

Group		Spinal & Continuous epidural anesthesia (n = 30)	Continuous epidural anestesia (n = 30)	T	p
TNF-α	T₁	62.41 ± 2.05	61.79 ± 2.03	0.546	0.512
	T₂	71.82 ± 2.64^a a p < 0.05.	78.59 ± 2.83^a a p < 0.05.	5.575	0.002
	T₃	85.37 ± 3.15^a a p < 0.05.	93.28 ± 3.61^a a p < 0.05.	0.683	0.412
IL-6	T₁	87.79 ± 3.15	88.94 ± 3.16	0.661	0.423
	T₂	95.26 ± 4.28^a a p < 0.05.	103.51 ± 4.75^a a p < 0.05.	5.784	0.002
	T₃	102.17 ± 4.51^a a p < 0.05.	109.17 ± 5.13^a a p < 0.05.	0.569	0.525

Group	Spinal & Continuous epidural anesthesia (n = 30)	Continuous epidural anestesia (n = 30)	T	p
Hypotension	1	1	‒	‒
Nausea, vomiting	1	2	‒	‒
Headache	0	2	‒	‒
Nerve damage	0	1	‒	‒
Postpartum hemorrhage	0	1	‒	‒
Total number	2	8	‒	‒
Total incidence (%)	6.67	23.33	6.136	0.001

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[1] *Corresponding author. E-mail address:ZhuoYinzyin@outlook.com (Z. Yin).