Effect of intrathecal labor analgesia using fentanyl 25 μg and bupivacaine 2.5 mg on progress of labor

Mathur, Pooja; Jain, Neena; Prajapat, Lokesh; Jain, Kavita; Garg, Deepak; Khandelwal, Vishal

doi:10.4103/2249-4472.194297

Cited by 9 publications

(11 citation statements)

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“…7 The mean duration of first stage of labor in the present study (193.82±25.300min) was relatively longer as compared to the study conducted by Owen MD et al (171±172min) and Mathur P et al (115.50±27.33min). 7,8 Difference could be because the study conducted by Mathur P et al had enrolled all the parturient in active phase of labor which is characterized by rapid cervical dilatation. Duration of second stage of labor in the study conducted by Viitanen H et al was significantly less (9.6±10.7min) as compared to present study (50.93±16.85min).…”

Section: Discussioncontrasting

confidence: 62%

“…12 All the parturients had normal vaginal delivery in the study conducted by Mathur P et al as the FHR abnormalities were transient and all caesareans were also excluded from the study whereas in the present study the subjects who delivered by caesarean section were not excluded from the study. 7 Overall caesarean rate was 10% among the parturients receiving single shot intrathecal labor analgesia and indications were fetal tachycardia (2%), fetal bradycardia (4%) and non progress of labor (4%). In the study conducted by Nelson KE et al, 55% delivered vaginally, 21% had IVD and the remaining 24% underwent caesarean section.…”

Section: Discussionmentioning

confidence: 95%

“…4 On the contrary the mean cervical dilatation at the time of administration of intrathecal analgesia in the study conducted by Tshibuyi PN et al (7.6±0.71) was higher and the mean cervical dilatation at the time of administration of intrathecal analgesia was lower in the study conducted by Nelson KE et al (4±1cm) and Mathur P et al (4.17±0.808cm). 6,7 This difference was due to the fact that intrathecal labor analgesia was administered at ≥5cm cervical dilatation in the study conducted by Tshibuyi PN et al 5 The mean rate of cervical dilatation in the present study was 1.472±0.4305cm/hour which was relatively less as compared to the study conducted by Mathur P et al, (3.02±0.584cm/hour) P value <0.001 however the mean cervical dilation in the present study was comparable to the cervical dilatation in Viitanen H et al study. 7 The mean duration of first stage of labor in the present study (193.82±25.300min) was relatively longer as compared to the study conducted by Owen MD et al (171±172min) and Mathur P et al (115.50±27.33min).…”

Section: Discussionmentioning

confidence: 99%

“…6,7 This difference was due to the fact that intrathecal labor analgesia was administered at ≥5cm cervical dilatation in the study conducted by Tshibuyi PN et al 5 The mean rate of cervical dilatation in the present study was 1.472±0.4305cm/hour which was relatively less as compared to the study conducted by Mathur P et al, (3.02±0.584cm/hour) P value <0.001 however the mean cervical dilation in the present study was comparable to the cervical dilatation in Viitanen H et al study. 7 The mean duration of first stage of labor in the present study (193.82±25.300min) was relatively longer as compared to the study conducted by Owen MD et al (171±172min) and Mathur P et al (115.50±27.33min). 7,8 Difference could be because the study conducted by Mathur P et al had enrolled all the parturient in active phase of labor which is characterized by rapid cervical dilatation.…”

Section: Discussionmentioning

confidence: 99%

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Effect of single low dose intrathecal labor analgesia on maternal and fetal outcome

Samyal

Thakur

Rao

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Labour is one of the most painful experiences women encounter during their lifetime and the experience is different for each women. Aim of the study was to evaluate the effect of low dose intrathecal labour analgesia using fentanyl, bupivacaine and morphine on maternal and fetal outcome.Methods: 100 parturients with uncomplicated pregnancy in spontaneous or induced labor at cervical dilatation 4-6cm were enrolled for the study. They were randomized into two groups of 50 each, using computer based block randomization. Group 1 (N=50) received intrathecal labor analgesia using. Fentanyl (25µg), bupivacaine (2.5mg) and morphine (250µg) and Group 2 (N=50) received programmed labor. The two groups were well matched in terms of age, weight, height, parity, baseline vitals and mean cervical dilatation at the time of administration of labor analgesia . Progress of labor, duration of analgesia, and neonatal APGAR score were recorded. Feto-maternal and neonatal outcomes were studied and compared between the two groups.Results: The mean duration of analgesia in group1 was 238.96±21.888 min whereas the mean duration of analgesia in group 2 was 98.4±23.505 min. The difference was significant P value 0.00. One out of 50 (2%) of the parturients required rescue analgesia in Group 1. On the contrary all 44 parturients in Group 2 required rescue analgesia. Difference was significant (p value=0.00) However duration of the stages of labor, operative and instrumental deliveries and APGAR score did not differ in the two groups.Conclusions: Single shot intrathecal labor analgesia is a safe, effective, reliable, cheap and satisfactory method of pain relief for labor and delivery. Moreover, it is devoid of major side effects.

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of single low dose intrathecal labor analgesia on maternal and fetal outcome

Samyal

Thakur

Rao

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…The shortest analgesia onset time and the highest sensory levels were recorded in group D followed by Masih & Gupta: Intrathecal Analgesia group F then group M with statistical significance between all of them. Visual analogue scale values were comparable among groups M, F and D (P > 0.05) at most of the measurement time points and at the peak of the last uterine contraction before delivery while being significantly lower than those in group C. We found that there was non-a Mathur et al, [11] included 60 women which were divided into Group SA (n = 30) received an intrathecal injection of 0.5% hyperbaric bupivacaine 2.5 mg and fentanyl 25 μg and group C (n = 30) who refused to give consent for neuraxial analgesia. It was found that the duration of the active phase of the first stage of labor was shortened in group SA as compared to group C (115.50 vs. 134.0 min, P < 0.05).…”

Section: Discussionmentioning

confidence: 46%

Assessment of Outcome of Intrathecal Analgesia in Multiparous Women Undergoing Vaginal Delivery

Masih¹,

Gupta²

2020

AAN

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Background: The present study was conducted to assess the outcome of intrathecal analgesia in multiparous women undergoing vaginal delivery. Subjects and Methods: The present study was conducted among 80 multiparous women ages ranged 18- 40 years. All patients received 0.5 ml of intrathecal injection of 2.5 mg bupivacaine 0.5% and 1 ml dexamethasone 4 mg plus a 0.5 ml adjuvant. The adjuvants in group I patients were 100 μg morphine, 25 μg fentanyl in group II, 5 μg dexmedetomidine in group III and normal saline in group IV (control group). The primary and secondary outcome was the duration of pain relief, the analgesia onset time, the maximum level of sensory block, the visual analogue scale (VAS) was recorded. Results: The mean duration of analgesia in group I was 182.4 minutes, in group II was 170.5 minutes, in group III was 200.4 minutes and in group, IV was 140.2 minutes. The onset of analgesia was 3.9 minutes, 2.8 minutes, 2.7 minutes and 4.5 minutes in group I, II, III and IV respectively. S1 sensory regression time (minutes) was 181.4, 157.4, 185.3 and 130.6 in group I, II, III and IV respectively. Modified Bromage scale 5 minutes, 15 minutes and 30 minutes after IT in all groups was 0.0. VAS was 1.3, 1.6, 1.6 and 3.1 with significant differences in all groups (P< 0.05). There was non- significant difference in mean age, weight, height and gestational age between all groups (P> 0.05). There was a non- significant difference in APGAR 1, 5, umbilical pH immediately after delivery, neonatal HR after 5minute, 15 minutes and 30 minutes in all groups (P> 0.05). Conclusion: The authors found that dexmedetomidine is a safe and effective adjuvant to intrathecal bupivacaine-dexamethasone in multiparous women undergoing normal vaginal delivery.

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Single-dose intrathecal analgesia: a safe and effective method of labor analgesia for parturients in low resource areas

Chauhan

Samyal

Pathania

2020

Ain-Shams J Anesthesiol

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Background Epidural analgesia is often said the gold standard of the labor analgesia. But in the areas where the availability of epidural catheters, multiparameter monitors, trained staff is scarce, we need to rethink for single-dose intrathecal analgesia as an alternate yet effective method to provide labor analgesia. The combination we chose for single-shot spinal was heavy bupivacaine 2.5 mg + fentanyl 25 μg + morphine 250 μg, so as to provide an optimal time period of analgesia and lesser need for supplemental analgesics. Methods The prospective open-label study was conducted on 100 parturients. Group S (N = 50) received intrathecal injection of 0.5 ml of heavy bupivacaine (2.5 mg) and 0.5 ml of fentanyl (25 μg), and 1 ml of preservative free morphine (250 μg/ml) was given (total volume of 2 ml) using 26 G Quincke spinal needle. Group C (N = 50) were managed according to the institutional protocol of programmed labor for normal vaginal delivery. The duration of analgesia, VAS score, safety and side effects, and progress of labor was noted and compared. Results The progress of labor, mode of delivery, and fetal parameters was similar in both the groups. But the parturients in the group S had lower VAS score with a pain-free period of 238.96 ± 21.88 min, without any noted side effects. Conclusion Single-dose intrathecal analgesia with heavy bupivacaine 2.5 mg + fentanyl 25 μg + morphine 250 μg can be used efficaciously covering the complete duration of labor in both primigravida and multigravida with no increase in instrumental delivery or C-section rate or other side effects. Trial registration Institutional Ethics Committee, Indira Gandhi Medical College, Shimla. Number: ECR/533/IST/HP/2014. Registered on 12 August 2017

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Effect of intrathecal labor analgesia using fentanyl 25 μg and bupivacaine 2.5 mg on progress of labor

Cited by 9 publications

References 0 publications

Effect of single low dose intrathecal labor analgesia on maternal and fetal outcome

Effect of single low dose intrathecal labor analgesia on maternal and fetal outcome

Assessment of Outcome of Intrathecal Analgesia in Multiparous Women Undergoing Vaginal Delivery

Single-dose intrathecal analgesia: a safe and effective method of labor analgesia for parturients in low resource areas

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