Continuous Epidural Infusion of Bupivacaine-Fentanyl During the Second Stage of Labor

Practice Guidelines for Obstetric Anesthesia

“…[74][75][76][77][78][79][80] A lower frequency of motor block was found for lower concentrations of local anesthetics (Category A1-B evidence). [74][75][76][78][79][80] ║║ The literature is insufficient to determine the effects of epidural local anesthetics with opioids on other maternal outcomes (e.g., hypotension, nausea, pruritus, respiratory depression, and urinary retention).…”

“…[62][63][64][65][66][67][68][69][70][71][72][73] Randomized controlled trials are equivocal for analgesic efficacy and duration of labor when continuous epidural infusion of low concentrations of local anesthetics with opioids are compared with higher concentrations of local anesthetics without opioids for maintenance of analgesia (Category A2-E evidence). [74][75][76][77][78][79] Meta-analyses of RCTs are also equivocal regarding spontaneous delivery and neonatal Apgar scores when continuous epidural infusion of low concentrations of local anesthetics with opioids are compared with higher concentrations of local anesthetics without opioids (Category A1-E evidence). [74][75][76][77][78][79][80] A lower frequency of motor block was found for lower concentrations of local anesthetics (Category A1-B evidence).…”

“…[74][75][76][77][78][79] Meta-analyses of RCTs are also equivocal regarding spontaneous delivery and neonatal Apgar scores when continuous epidural infusion of low concentrations of local anesthetics with opioids are compared with higher concentrations of local anesthetics without opioids (Category A1-E evidence). [74][75][76][77][78][79][80] A lower frequency of motor block was found for lower concentrations of local anesthetics (Category A1-B evidence). [74][75][76][78][79][80] ║║ The literature is insufficient to determine the effects of epidural local anesthetics with opioids on other maternal outcomes (e.g., hypotension, nausea, pruritus, respiratory depression, and urinary retention).…”