Abstract: Objective：To investigate the effect of multimodal analgesia in total stage of labor on maternal and infant safety. Methods：300 full-term pregnant woman with single fetuses, aged 23-36 yr, weighing 61-95 kg, whose height were between 155-172 cm and have been pregnant for 38-41 weeks, were randomly divided into three groups: epidural anesthesia labor analgesia in active period (Group A, n =100), epidural anesthesia labor analgesia in total stage of labor (Group B, n =100) and TENS combined with epidural anesthesia labor analgesia in total stage of labor (Group C, n=100). VAS scores at different time, labor time, volume of postpartum hemorrhage, the rate of using pitocin, Apgar score and blood gas analysis to fetal umbilical blood were recorded. Blood samples were taken from three groups at the time of labor (T0) and complete cervical dilation (T1) to test the concentrations of β-endorphin, norepinephrine, epinephrine and blood sugar. Results：The VAS scores of group B, C at each point in incubation period of labor, were significantly lower than those of group A(P＜0.05). The first stage of labor and the rate of using pitocin in group A, C were shorter than those in group B (P＜0.05). There was no significant difference in the volume of postpartum hemorrhage, Apgar score and blood gas analysis of fetal umbilical blood in three groups (P＞0.05). Compared with T0, the concentrations of blood β-endorphin, norepinephrine, epinephrine and blood sugar in three groups significantly increased at T1 (P＜0.05). The concentration of β-endorphin at T1 was significantly higher in group C than that in group A and group B (P＜0.05). Norepinephrine, epinephrine and blood sugar concentrations in group B and group C were lower than those in group A (P＜0.05). Conclusions：Multimodal labor analgesia in total stage of labor can reduce the rate of using pitocin, avoid influences on stage of labor and the outcome of perinatal, protecting the safety of maternal and infant while improving the effect of labor pain in the first place.

Key words: Analgesia, obstetrical, Analgesia, epidural, Transcutaneous electric nerve stimulation, Acupuncture points, Stage of labor