Effect of combined spinal–epidural analgesia versus epidural analgesia on labor and delivery duration

Pascual-Ramírez, Javier; Haya, Javier; Pérez‐López, Faustino R.; Gil-Trujillo, Silvia; Garrido-Esteban, Rosa A.; Bernal, G.

doi:10.1016/j.ijgo.2011.04.004

Cited by 29 publications

(21 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among the patients receiving tramadol, 10 patients had nausea and 16 patients developed vomiting which was found to be statistically significant. Major side effect in the patients receiving tramadol was nausea and vomiting which is attributable to its action through 5-hydroxytryptamine receptor 14,15 .The present study is comparable to study of Long et al 10 and Chatrath et al 12 which also showed similar results. Tramadol is known to cause higher incidence of nausea and vomiting 16 .…”

Section: P Valuesupporting

confidence: 90%

Epidural tramadol improves the quality of pain relief during labor

et al. 2017

View full text Add to dashboard Cite

To study the analgesic efficacy and side effects of Tramadol for painless labor in combination with Bupivacaine. Randomized, controlled, double blind, open prospective study conducted at Department of Obstetrics and Gynaecology, Chitwan Medical College from July 1st 2015 to June 30th 2016. 100 patients of ASA Grade I and II, aged between 20-35 years willing for epidural analgesia for labor pain were included in the study. They were divided into two groups: Group A-Control group and Group B-Study group. Subjects of Group A received 10 ml of 0.25% Bupivacaine and that of Group B received 10ml of 0.25% Bupivacaine with 1mg/kg body weight of tramadol. Analgesic efficacy was assessed by Visual Analogue Scale (VAS) and other vital parameters (Blood Pressure, Heart Rate and Respiratory Rate) before the administration of the drug and at different time intervals of 0, 5 min, 10 min, 15 min, 30 min, 45 min, 60 min and every hourly up to maximum of 5 hrs. Neonatal out comes were assessed by the use of APGAR scores and the side effects of the drugs in two groups were also evaluated. Total number of patients was 100, of ASA Grade I and II, aged between 20-35 years. The mean age of patients in Group A was 23.54 ± 3.74 years and 24.22 ± 3.64 years in Group B. Mode of delivery was spontaneous vaginal in 42 patients (84%) in group A and 45 patients (90%) in group B. Instrumental vaginal delivery was done in 1 patient (2%) of group A and none of group B. Cesarean section was done in 7 patients (14%) of group A and 5 patients (10%) of group B. There was no significant difference in heart rate, blood pressure and respiratory rate at various time intervals. Pain score of Group B was significantly less at 60th min and had lower values than Group A at various time intervals. Time for first top up was significantly delayed and the total dose of bupivacaine was significantly lower in Group B patients but the incidence of nausea and vomiting was significantly high among Group B patients. At one minute majority of the babies of group A had mean APGAR score 6.98 ± 0.55 versus 7.18 ± 0.60 in group B. At 5 minute, Group A had mean score of 8.02 ± 0.47 versus 8.22 ± 0.58 in Group B. There were no significant differences in 2 groups. In both the groups there was no significant effect on duration of second stage of labor and it wasn't prolonged in any of the patients. Epidural anesthesia with bupivacaine and tramadol provided better pain relief and reduced the total dose of bupivacaine in majority of the patients with no adverse effects on mother and fetus. As tramadol is cheap, safe and effective, it can be considered as a better option to improve quality of pain relief during labor.

show abstract

Section: P Valuesupporting

confidence: 90%

Epidural tramadol improves the quality of pain relief during labor

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Especially, the combined use of local anesthetic and opioid analgesics, also called balanced analgesia method, can reduce the doses of each drug and reduce the side effects of drugs, which can effectively inhibit metabolic and endocrine responses resulting from nociceptive stimulation [22,23]. Some previous studies have revealed that after some thoracic and gynecological operations, PCEA presented more merits in postoperative analgesia than PCIA and could effectively relieve pain both on coughing and at rest [24,25]. Besides, PCEA can relieve postoperative stress as well as can offer a fast recovery of intestinal activity after operations [26].…”

Section: Introductionmentioning

confidence: 99%

Comparison of pain relief between patient-controlled epidural analgesia and patient-controlled intravenous analgesia for patients undergoing spinal fusion surgeries

Wang

et al. 2015

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

show abstract

“…15 PCEA is also better than PCIA at relieving pain, both at rest and on coughing, following thoracic and gynecological surgery. 30,31 Furthermore, epidural catheters can be placed at multiple locations to cover larger areas of pain, which is important in complex surgical settings, such as in spinal tumors. 32 PCEA also enables fast recovery of gastrointestinal activity after surgery, requiring less postoperative care.…”

Section: Discussionmentioning

confidence: 99%

Effects of Patient-Controlled Epidural Analgesia and Patient-Controlled Intravenous Analgesia on Analgesia in Patients Undergoing Spinal Fusion Surgery

Lu²,

Ma³

et al. 2016

American Journal of Therapeutics

View full text Add to dashboard Cite

We compared the outcomes of patient-controlled epidural analgesia (PCEA) and patient-controlled intravenous analgesia (PCIA) in analgesia after spinal fusion surgery. A total of 120 patients who underwent spinal fusion surgeries between April 2013 and April 2015 at Shaanxi Provincial People's Hospital were selected for this study based on defined inclusion criteria. All patients were randomly divided into 2 groups before surgery: PCEA group (n = 65) and PCIA group (n = 55). Visual analog scales (VAS) were used to evaluate the degree of pain. Besides, the active and passive activities of patients during 1- to 3-day recovery period after surgery were recorded. Verbal rating scales were used to measure pain levels after surgery and after surgery. Adverse effects of PCEA and PCIA were monitored, which included nausea, vomiting, pruritus, drowsiness, respiratory depression, and headache. Our results showed no statistically significant differences between PCEA and PCIA in sex ratio, age, height, weight, American Society of Anesthesiologists level, surgery time, number of fusion section, surgery methods, and duration of anesthesia (all P > 0.05). The PCEA group was associated with significantly lower VAS scores, compared with the PCIA group, at 3, 6, 12, 24, and 48-hour postsurgery (all P < 0.05) when surgery-associated pain is expected to be intense. Also, compared with the PCIA group, the PCEA group showed higher frequency of recovery activities on first and second day postsurgery (all P < 0.05). The overall patient satisfaction level of analgesia in the PCEA group was significantly higher than in the PCIA group (P < 0.05). Moreover, the incidence of hypopiesia and skin itching in the PCIA group was higher than in the PCEA group (all P < 0.05). Finally, drowsiness and headache were markedly lower in the PCIA group after surgery, compared with the PCEA group, and this difference was statistically significant (all P < 0.05). Our results provide strong evidence that PCEA exhibits significantly greater efficacy than PCIA for pain management after spinal fusion surgery, with lower VAS scores, higher frequency of recovery activities, and overall higher satisfaction level.

show abstract

Effect of combined spinal–epidural analgesia versus epidural analgesia on labor and delivery duration

Abstract: As compared with LEA, CSEA did not shorten the duration of labor length; however, it did reduce levobupivacaine consumption and motor weakness.

Cited by 29 publications

References 21 publications

Epidural tramadol improves the quality of pain relief during labor

Epidural tramadol improves the quality of pain relief during labor

Comparison of pain relief between patient-controlled epidural analgesia and patient-controlled intravenous analgesia for patients undergoing spinal fusion surgeries

Effects of Patient-Controlled Epidural Analgesia and Patient-Controlled Intravenous Analgesia on Analgesia in Patients Undergoing Spinal Fusion Surgery

Contact Info

Product

Resources

About