Combined spinal epidural analgesia with ability to walk throughout labour

Collis, Rachel; Baxandall, M.L.; Srikantharajah, Indra; Edge, G.; Kadim, M. Y.; Morgan, B.

doi:10.1016/0140-6736(93)90548-u

Cited by 88 publications

(37 citation statements)

References 3 publications

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“…[1][2][3][4][5] The initial single-injection spinal component produces rapid onset but unsustained analgesia. Subsequently, the epidural catheter can be used to extend and provide continuous pain relief.…”

Section: Résumémentioning

confidence: 99%

Low-dose intrathecal local anesthetic does not increase the threshold current for the epidural stimulation test: a prospective observational trial of neuraxial analgesia in labouring women

Carvalho

Khemka

Loke

et al. 2014

Can J Anesth/J Can Anesth

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Section: Résumémentioning

confidence: 99%

Low-dose intrathecal local anesthetic does not increase the threshold current for the epidural stimulation test: a prospective observational trial of neuraxial analgesia in labouring women

Carvalho

Khemka

Loke

et al. 2014

Can J Anesth/J Can Anesth

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“…16,17 However, low-dose combined spinal epidural for labour analgesia have been shown to protect muscle power and improve patient satisfaction, compared to standard epidural analgesia. 11,18 Further evidence suggests that combined spinalepidural analgesia does not impair balance function in labouring women. 19,20 The suitability of intrathecal narcotics for labour analgesia in low-resource settings has been examined in previous reports, but their impact on mobility has not been considered.…”

Section: Introductionmentioning

confidence: 99%

Low-dose spinal anaesthesia provides effective labour analgesia and does not limit ambulation

Anabah

Olufolabi

Boyd

et al. 2015

Southern African Journal of Anaesthesia and Analgesia

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Background: While epidural analgesia for labour pain is standard in high-resource countries, minimal to no analgesia is usually provided in low-resource countries. Intrathecal local anaesthetics provide good pain relief, but the potential impact on ambulation is of concern. Our objective was to determine if a low-dose local anaesthetic combined with an opioid would provide reasonable pain relief, while allowing ambulation in a low-resource setting. Method: This prospective, observational study was conducted at the Tamale Teaching Hospital in Tamale, Ghana. Spinal analgesia was administered to healthy women in labour using a pencil-point 25-G spinal needle at the L3-L4 or L4-L5 interspace, with patients in the sitting position. The intrathecal mixture contained 25 μg of fentanyl, 2.5 mg of bupivacaine and 0.2 mg of morphine. The patient's ability to ambulate following the administration of a low-dose spinal injection was the primary outcome measured. Pain ratings, blood pressure, nausea, vomiting, pruritus, headaches and foetal bradycardia were also recorded. Results: Three hundred and thirty-two parturients consented to participate. Following spinal injection, 328 women (98.8%) experienced mild to no pain, and 4 (1.2%) moderate pain. The administration of spinal analgesia had no effect on ambulation in 291 (87.7%) patients, and a mild effect in 41 (12.3%) patients. Intrathecal analgesia did not severely limit ambulation in any of the patients. Conclusion: Low-dose intrathecal analgesia can provide effective analgesia for labouring patients in low-resource settings without limiting ambulation.

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“…La anestesia regional fue descrita en 1937, pero no fue hasta los años ochenta que se intentó utilizar en clínica, con resultados poco alentadores. Sin embargo, con el desarrollo de la técnica y la demostración de su seguridad se ha determinado la masificación de esta técnica para analgesia en trabajo de parto y anestesia en cesárea en distintos países (6).…”

Section: Introductionunclassified

Partograma en Mujeres Multíparas Con Manejo Médico Del Trabajo De Parto

et al. 2007

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes. La evaluación gráfica del parto fue descrito originalmente por Friedman, sin embargo, una descripción de la evolución del trabajo de parto con un manejo médico contemporáneo no ha sido completamente evaluado. Objetivo: Analizar el efecto de un manejo médico estandarizado del trabajo de parto, que incluye anestesia regional, rotura artificial de membranas y conducción ocitócica, sobre la fase activa del trabajo de parto en multíparas. Método. Análisis retrospectivo de 130 multíparas en trabajo de parto espontáneo, que ingresaron con 3 a 4 cm de dilatación. Resultados. Se observó una duración de la fase activa del trabajo de parto de aproximadamente 3,5 horas, con una progresión promedio de 1,5 cm/ h, produciéndose la mayor progresión entre los 7 y 9 cm de dilatación con 1,9 cm/h. La segunda fase del trabajo de parto presento una duración promedio de 28 minutos. Conclusiones. Nuestros resultados muestran que el manejo "médico estandarizado" del trabajo de parto no reduce los tiempos de la fase activa ni de la segunda fase en multíparas. Creemos que es necesario implementar estudios randomizados para determinar la influencia de este tipo manejo del trabajo de parto en la incidencia de cesáreas. PALABRAS CLAVES: Partograma, parto, multíparas, manejo del parto SUMMARYObjective. To analyze the influence of a standardised protocol for the management of labour applied during the active phase of labour. Method. The graphic partograms of 130 multiparous women with spontaneous onset of labor were retrospectively analysed. A standardised protocol was defined by use of regional anaesthesia, early rupture of membranes and oxytocin acceleration during the active phase of labour. Results. The mean duration of the active phase of labour and the mean cervical rate dilatation were approximately 3.5 hours and 1.5 cm/h, respectively. The maximum mean rate of dilatation was 1.9 cm/h at the range of 7 to 9 cm, being the mean duration of the second phase of labour only 28 minutes. Conclusions. This study shows that the application of this standardised protocol of management of labour do not appear to be associated with a shortenning in the duration of the active dilatation and second stage of labour. Therefore, it would be necessary to set up a randomized control trial to evaluate the influence of this kind of managements in the caesarean section rate.

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Combined spinal epidural analgesia with ability to walk throughout labour

Cited by 88 publications

References 3 publications

Low-dose intrathecal local anesthetic does not increase the threshold current for the epidural stimulation test: a prospective observational trial of neuraxial analgesia in labouring women

Low-dose intrathecal local anesthetic does not increase the threshold current for the epidural stimulation test: a prospective observational trial of neuraxial analgesia in labouring women

Low-dose spinal anaesthesia provides effective labour analgesia and does not limit ambulation

Partograma en Mujeres Multíparas Con Manejo Médico Del Trabajo De Parto

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