Abstract: Objective To investigate the effects of combined subarachnoid and epidural analgesia (CSEA) using sufentanil plus ropivacaine on neonates.Methods A total of 100 full term primiparae with singleton and cephalic presentation and without contraindications for intraspinal anesthesia or vaginal delivery were selected and randomly divided into two groups.Group Ⅰ (n=50) was given a mixture of 0.5mg/L sufentanil and 0.1% ropivacaine for 1.5 ml single-dose subarachnoid anesthesia and 15 min 5 ml/h patient-controlled epidural analgesia; group Ⅱ (n=50) was given 0.1% ropivacaine for 1.5 ml single-dose subarachnoid anesthesia and 15 min 5 ml/h patient-controlled epidural analgesia.The analgesic effects were then observed,and VAS scoring was recorded at 10 (T1),30(T2),60(T3)and 120 min(T4),as well as the drug volume in analgesia pump,the number of total press (D1)/number of practical and effective drug (D2).The blood gas analysis was immediately performed after the birth of neonates in two groups,and the Apgar score was recorded.The neurological assessment (NBNA),neonatal jaundice index,weight and blood sugar were determined in 5 consecutive days after birth of the neonates.Results There were no significant differences in VAS scoring during T1 to T4 between two groups of puerperas.The two groups showed no difference in D1/D2 ratio at T1 and T2,but group Ⅱ had a higher D1/D2 ratio than group Ⅰ at T3 and T4 (2.5±1.0 vs 1.5±0.9,2.8±1.2 vs 2.1±0.6,all P<0.05).The total drug volume in analgesia pump in group Ⅱ was also higher than that in group Ⅰ [ (21.2±3.1)ml vs (12±4.5) ml,P<0.05].No significant difference was found in NBNA,neonatal jaundice index,the decreased weight and blood sugar between the two groups of neonates within 5 d after birth.Conclusion CSEA using 0.5 mg/L sufentanil plus 0.1% ropivacaine can provide the favorable analgesia efficacy for puerperas and safety for the neonates.