Bupivacaine with Meperidine versus Bupivacaine with Fentanyl for continuous epidural labor analgesia

To compare the efficacy of bupivacaine-meperidine and bupivacaine-fentanyl mixtures when continuously infused epidurally to relief the labor pain. We performed this prospective double-blinded study at Jordan University Hospital, Amman, Jordan between October 2005 and April 2006. Sixty-seven American Society of Anesthesia physical status I parturients were randomly divided into 2 groups, Group M [n=34] received a continuous infusion of 1 mg/ml of bupivacaine mixed with 1 mg/ml meperidine, and Group F [n=33] received a continuous infusion of 1 mg/ml bupivacaine mixed with 2 micrometer/ml fentanyl. Efficacy of analgesia, degree of motor block, hemodynamic variability, incidence of nausea and vomiting, pruritus, sedation, and the neonatal outcome were all compared between the 2 groups. A p value<0.05 was considered to be significant. Highly effective analgesia was achieved in both groups with a similar incidence of motor block, sedation, pruritus, and neonatal outcome. The only significant difference was in the incidence of nausea and vomiting. Group M had 8 parturients with nausea, compared with only 2 parturients in Group F [p=0.003]. Bupivacaine-meperidine in a continuous epidural infusion is as efficient as bupivacaine-fentanyl for pain relief during labor, but associated with a higher incidence of nausea and vomiting

Routine care of normal deliveries as applied in Syrian maternity wards

routine practices during normal childbirth have not been studied in Syria. Our study was designed to describe the routines of normal childbirth as practiced in maternity wards in Syrian hospitals and to assess whether these routines are in accordance with the best evidence-based practices. a nationally representative sample of 57 hospitals was visited: 33 were government hospitals and 24 were private hospitals. The personnel in charge were interviewed using a specially designed questionnaire that covered both management and technical points. only 2 of the 57 hospitals had a written policy concerning childbirth, although 29 had a written breast-feeding policy. All except two hospitals reported the capability of doing a cesarean section at any time. Results on hospital routines are presented in the light of the available best-evidence guidelines. the study highlights the urgent necessity to formulate a national policy for care in normal birth. This policy needs to be designed bearing in mind the best evidence available and the nature of the national setting