Combined spinal-epidural technique versus epidural technique for labor analgesia

M. Lerinţiu, K.Orosz, Marcela Voicu, Georgeta Tudorică, C.Truşcă
Secţia ATI, Clinica Ginecologie I, Spitalul Clinic Judeţean Cluj-Napoca

Abstract

Aim. To compare spinal-epidural vs. epidural techniques for labor analgesia.

Material and method. We studied 60 parturients in labor divided in 3 groups: the ES group which received a combined spinal-epidural analgesia with bupivacaine and fentonyl; the PB group which received an epidural analgesia with bupivacaine and the PR group which received an epidural analgesia with ropivacaine. The following parameters were evaluated: the onset of sensory block, the percentage of reduction of pain, the height of the block, the duration of analgesia, intensity of motor block, haemodynamic parameters, incidence of complications (pruritus, nausea, vomiting, urinary retention, headache), duration of the first and second stage of labour, the need for oxitocin, the mode of delivery (normal or instrumental-forceps, caesarean section), the condition of the foetus (deceleration, APGAR scores).

Results. The percentage of the reduction of pain was: at 5 min ES 78%, PB 27.5%, PR 27%; at 10 min ES 93%, PB 56%, PR 57%; at 15 min ES 94%, PB 81%, PR 82%. The height of the sensory block to T7-T8 and the duration of analgesia of 90-100 minutes were similar. The intensity of motor block was: ES group without motor block, PB 15% grade I, PR 10% grade I. The incidence of hypotension: ES 5%, PB 15%, PR 20%. There were no significant differences concerning the incidence of the adverse events.

Conclusions. In the ES group the time required to obtain analgesia was significantly shorter, the quality of analgesia was better without motor block (ambulation was better) and the incidence of hypotension was lower.

Key words: combined spinal epidural analgesia, epidural analgesia, labor analgesia

Tehnica combinată epispinală versus epidurală în analgezia la naştere

Jurnalul Român de Anestezie Terapie intensivă 2004 Vol.11 Nr.2, 111-116