Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia

Abstract

Objectives: This study aimed to compare the analgesic effect of single-dose spinal versus epidural analgesia for labor pain to verify if applying a single dose spinal analgesia is an efficient technique for labor pain management as an alternative for epidural analgesia. Methods: A total of 128 women in the active phase of labor were randomly allocated into two groups of spinal analgesia (n = 64) and epidural analgesia (n = 64). The latter received a bolus dose of 16 mL of 0.125% bupivacaine and 50 μg fentanyl and repeated 5 - 10 mL of bolus dose. The former received 2.5 mg hyperbaric bupivacaine plus 50μg fentanyl. Pain intensity was measured using the visual analog scale (VAS). The duration of analgesia, mode of delivery, the duration of labor, side effects, and maternal satisfaction were also compared. Results: There were no significant differences in the rate of cesarean section, duration of labor, postpartum hemorrhage, and the frequency of the fetal heart deceleration until 30 min after analgesia between the two groups. Measured pain after 30 (P = 0.0001) and 90 min (P = 0.01) was significantly lower in the spinal group than the epidural group. However, there was no significant difference between the spinal and epidural groups concerning the VAS scores at 150, 210, and 270 minutes. Maternal satisfaction was higher in the spinal group (P = 0.002). The mean duration of analgesia was longer in the spinal group than the epidural group (P = 0.0001). Conclusions: According to the findings, single-dose spinal analgesia, compared to epidural analgesia, is a safe, fast, and efficient technique for labor analgesia, which can be easily performed. In addition, it provides a high satisfaction level in the parturient.

Effect of spinal anesthesia with sufentanil on length of stages I and II of labor in singleton pregnant women: a randomized controlled trial

“…Other researchers reported no significant increase in the length of stages of labor by singledose spinal analgesia with 2.5mg hyperbaric bupivacaine plus 50 μg fentanyl. (20) The heterogeneity between studies can be due to the fact that each of these studies used a specific dosage and type of medication for anesthesia. Rahmati et al (20) in their trial used a 0.5 mL (2.5 mg) dosage of hyperbaric bupivacaine 0.5% combined with 50 μg fentanyl and suggested this combination as a safe method for spinal analgesia with no significant complication.…”

“…(20) The heterogeneity between studies can be due to the fact that each of these studies used a specific dosage and type of medication for anesthesia. Rahmati et al (20) in their trial used a 0.5 mL (2.5 mg) dosage of hyperbaric bupivacaine 0.5% combined with 50 μg fentanyl and suggested this combination as a safe method for spinal analgesia with no significant complication. Our results showed that the control group's mean lengths of both first and second stages were even longer than those of the spinal anesthesia group (121 ± 187.68 min vs. 92 ± 152.33 min, and 20.90 ± 26.42 min vs. 14.26 ± 15.96 min, respectively).…”

Transversus abdominis plane block improves postoperative recovery following cesarean delivery under general anesthesia: A propensity score matched retrospective cohort study

“…[4][5][6] Spinal anesthesia is used in many elective cesarean deliveries, and epidural anesthesia is still the standard technique for postoperative analgesia for cesarean delivery. 7,8 However, there are contraindications to spinal puncture including thrombocytopenia, anticoagulant therapy, or lumbar disease. For women with these conditions, general anesthesia is conducted, and alternative methods of pain relief are necessary.…”

Comparison of the outcomes of normal vaginal delivery with and without spinal anesthesia in mothers admitted to the maternity ward of Firoozabadi Hospital

“…[ 9 ] Of course, the absence of pain after normal vaginal delivery with spinal anesthesia has been proven in many studies and this advantage is very important in terms of maternal comfort and pain relief. [ 18 19 ]…”