Comparing epidural surgical anesthesia and spinal anesthesia following epidural labor analgesia for intrapartum cesarean section: a prospective randomized controlled trial / 대한마취과학회지
Korean Journal of Anesthesiology
;
: 412-419, 2017.
Article
in English
| WPRIM
| ID: wpr-36825
ABSTRACT
BACKGROUND:
The conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum cesarean section (CS) often fails, resulting in intraoperative pain. Spinal anesthesia (SA) can provide a denser sensory block than ESA. The purpose of this prospective, non-blinded, parallel-arm, randomized trial was to compare the rate of pain-free surgery between ESA and SA following ELA for intrapartum CS.METHODS:
Both groups received continuous epidural infusions for labor pain at a rate of 10 ml/h. In the ESA group (n = 163), ESA was performed with 17 ml of 2% lidocaine mixed with 100 µg fentanyl, 1 200,000 epinephrine, and 2 mEq bicarbonate. In the SA group (n = 160), SA was induced with 10 mg of 0.5% hyperbaric bupivacaine and 15 µg fentanyl. We investigated the failure rate of achieving pain-free surgery and the incidence of complications between the two groups.RESULTS:
The failure rate of achieving pain-free surgery was higher in the ESA group than the SA group (15.3% vs. 2.5%, P < 0.001). There was no statistical difference between the two groups in the rate of conversion to general anesthesia; however, the rate of analgesic requirement was higher in the ESA group than in the SA group (12.9% vs. 1.3%, P < 0.001). The incidence of high block, nausea, vomiting, hypotension, and shivering and Apgar scores were comparable between the two groups.CONCLUSIONS:
SA after ELA can lower the failure rate of pain-free surgery during intrapartum CS compared to ESA after ELA.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Shivering
/
Vomiting
/
Bupivacaine
/
Epinephrine
/
Cesarean Section
/
Fentanyl
/
Incidence
/
Prospective Studies
/
Labor Pain
/
Analgesia
Type of study:
Controlled clinical trial
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Pregnancy
Language:
English
Journal:
Korean Journal of Anesthesiology
Year:
2017
Type:
Article
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