Combined spinal-epidural analgesia and epidural analgesia in labor: effect of intrathecal fentanyl vs. epidural bupivacaine as a bolus.
Article
in English
| IMSEAR
| ID: sea-43988
ABSTRACT
OBJECTIVE:
To compare the clinical effects of intrathecal fentanyl with conventional epidural bupivacaine bolus before the same continuous epidural infusion for labor analgesia. MATERIAL ANDMETHOD:
Fifty parturients in active labor were randomized to receive subarachnoid fentanyl 25 mcg as part of a combined spinal epidural analgesia (CSE) or bupivacaine 0.25% 10 ml incrementally into the epidural space in the epidural group. After that, 0.0625% bupivacaine with fentanyl 2 mcg/ml was infused via epidural catheter in all women at a rate of 12 ml/h. Verbal numeric pain scores (VNPS), onset time to pain relief times of additional analgesia and other side effects were recorded.RESULTS:
Mean (SD) onset time to the first pain free contraction was not significantly different (7.8 +/- 4.3 min in the CSE group, 10.2 +/- 5.1 min in epidural group, p = 0.085). Most of the patients in the CSE group required additional epidural bolus dose (80% compared to 48% in the Epidural group, p = 0.038). There was no difference in motor blockage at time of delivery or mode of delivery. Significantly more women in the CSE group had pruritus (68% VS none in the epidural group, p < 0.001), all had mild degree and did not require any treatment. There was no difference in other side effects.CONCLUSION:
Intrathecalfentanyl as part of CSE did not produce statistically a significant faster onset compared to epidural bupivacaine bolus. Most of the patients in the CSE group required epidural bolus after intrathecal fentanyl with a higher incidence of pruritus.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Bupivacaine
/
Female
/
Humans
/
Pregnancy
/
Analgesia, Epidural
/
Fentanyl
/
Adult
/
Labor Pain
/
Drug Therapy, Combination
/
Analgesics, Opioid
Type of study:
Controlled clinical trial
Language:
English
Year:
2007
Type:
Article
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