Neuraxial Homeostasis - Optimizing Neuraxial Labor Analgesia.

At present, few studies on labor analgesia focus on preventing and managing neurological complications, and there is a lack of specific operational guidelines for clinical practice. This study aims to compare spinal analgesia-epidural analgesia (SA-EA) and combined spinal-epidural analgesia (CSEA) in reducing neurological complications during labor analgesia. SA-EA group: A standard spinal needle (0.5 × 113mm) was first inserted to perform a dural puncture, and 2mL of 0.1% ropivacaine + 1µg/mL sufentanil was injected intrathecally. After the spinal needle was withdrawn, a standard epidural needle (1.6 × 80mm) was used to perform an epidural puncture, and an epidural catheter (1.0mm) was inserted approximately 4cm into the epidural space. Twenty minutes later, an epidural analgesia pump was connected. CSEA group: A standard epidural needle (1.6 × 80mm) was first inserted for epidural puncture. A spinal needle was then passed through the epidural needle to perform a dural puncture, and 2mL of 0.1% ropivacaine + 1µg/mL sufentanil was injected intrathecally. After the spinal needle was removed, an epidural catheter (1.0mm) was inserted approximately 4cm into the epidural space. Twenty minutes later, an epidural analgesia pump was connected. We hypothesize that there may be differences in the incidence of neurological complications between the two groups. It is pioneering and significant as it starts from actual clinical operations. By in-depth comparing SA-EA and CSEA techniques, the study is expected to provide important references for clinical practice, improving the safety and efficacy of labor analgesia and reducing neurological complications. Additionally, it is the first time to propose the concept of neuraxial homeostasis in the anesthesia field, which is of great importance to the development of the discipline.