Does epidural versus combined spinal-epidural analgesia prolong labor and increase the risk of instrumental and cesarean delivery in nulliparous women?

被引：14

作者：

Aneiros, Francisco ^{[1
,2
]}

Vazquez, Miriam ^{[1
,2
]}

Valino, Cristina ^{[1
,2
]}

Taboada, Manuel ^{[1
,2
]}

Sabate, Sergi ^{[3
]}

Otero, Pablo ^{[1
,2
]}

Costa, Jose ^{[1
,2
]}

Carceller, Javier ^{[1
,2
]}

Vazquez, Rocio ^{[1
,2
]}

Diaz-Vieito, Maria ^{[1
,2
]}

Rodriguez, Alfonso ^{[1
,2
]}

Alvarez, Julian ^{[1
,2
]}

机构：

[1] Univ Santiago de Compostela, Dept Anesthesiol, Santiago De Compostela 15706, Spain

[2] Hosp Clin Univ Santiago, Santiago De Compostela 15706, Spain

[3] Fdn Puigvert INUA, Dept Anesthesiol, Barcelona 08025, Spain

来源：

JOURNAL OF CLINICAL ANESTHESIA | 2009年 / 21卷 / 02期

关键词：

Analgesia; Obstetrical; Analgesic techniques; Combined spinal-epidural; Epidural; Subarachnoid; BUPIVACAINE; LEVOBUPIVACAINE; ROPIVACAINE; SUFENTANIL; INFUSION;

D O I：

10.1016/j.jclinane.2008.06.020

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Study Objective: To compare duration of labor, mode of delivery, and local anesthetic consumed in women who received labor analgesia with epidural or combined spinal-epidural technique. Design: Retrospective, observational study. Setting: Delivery room of a university hospital. patients: 788 nulliparous women in labor at term with cervical dilation between three and 5 cm. Interventions: In Group E (epidural alone), parturients received an epidural solution of 8 mL (levobupivacaine 0.125% with fentanyl 5 mu g/mL). In Group CSE (combined spinal-epidural), parturients received a spinal injection of levobupivacaine two mg with fentanyl 15 mu g (total volume two mL). Then an epidural catheter was placed in all patients and connected to a patient-controlled analgesia pump (basal infusion rate of 8 mL/hr of 0.1% levobupivacaine and fentanyl two mu g/mL, patient-controlled bolus dose of three mL, and lockout time of 30 min). Measurements: Labor duration, mode of delivery (spontaneous vaginal vs. instrumental delivery vs. cesarean section), and local anesthetic consumed, were recorded. Main Results: Labor analgesia was performed with an epidural technique in 322 patients (40.9%), and a combined spinal-epidural technique in 466 patients (59.1%), of whom 39 Group E women (12.1%) and 46 Group CSE women (9.9%) required cesarean section (P=ns). No differences in the mode of delivery were observed between the groups. Time from analgesia to delivery (Group E: 217 +/- 111 min vs. Group CSE: 213 +/- 115 min; P=ns), and epidural local anesthetic consumed (Group E: 35 +/- 20 mL vs. Group CSE: 33 20 mL; P=ns), were similar in both groups. Conclusions: No significant differences were observed between epidural and combined spinal-epidural given for labor analgesia in nulliparous women in duration of labor, mode of delivery, or local anesthetic consumed. (c) 2009 Elsevier Inc. All rights reserved.

引用

页码：94 / 97

页数：4

共 15 条

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