Epidural analgesia in labour

McGrady, Elizabeth; Litchfield, K.

doi:10.1093/bjaceaccp/mkh030

Cited by 26 publications

(21 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Some studies report benefits for the neonate, including a reduction in the incidence of low APGAR scores at 5 min and in the need for NICU admissions. Other workers have reported transient alterations in the foetal heart rate, particularly bradycardias, after initiation of epidural analgesia [12] . In our study,the difference between the rate of admission in NICU was not significant statistically.…”

Section: Discussionmentioning

confidence: 96%

Cervicographic progress in active Phase and obstetric outcome in Patients undergoing labour under Epidural analgesia

Goel¹

2017

int.jour.sci.res.mana

View full text Add to dashboard Cite

Objective: To analyze the progress of labour and then the obstetric and fetal outcome of the patients who received epidural analgesia in labor and comparing them with those who did not receive epidural analgesia. Study design: Hospital based prospective comparative study. Methodology: The study involved 200 patients who were divided into 2 groups on the basis of whether they received epidural analgesia or not, with 100 patients in each group. The advantages and disadvantages of epidural analgesia were evaluated. Results: When compared with the non-epidural analgesia group (n = 100), the group that received epidural analgesia (n = 100) had significant prolongation in the duration of first and the second stage of labour and higher likelihood of instrumental delivery. 57.4% patients in the epidural group delivered to the left of the progress line whereas 69.6% patients in the control group delivered to the left. There was also an increased incidence of caesarean deliveries in the epidural group as compared to the control group but the difference was not significant statistically (20% Vs 17%, p>0.05). There was no difference in the neonatal outcome of the patients who received epidural analgesia as compared to control group. Moreover, pain relief and maternal satisfaction was excellent in patients who requested epidural analgesia. Conclusion: Compared with other techniques, epidural analgesia is the most effective form of analgesia. Factors contributing to the progress and outcome of labour are multiple and complex. Epidurals do not increase caesarean section rates. However, we must strive to reduce any effect on duration of labour and instrumental vaginal delivery rates by minimizing motor block through the use of low dose local anaesthetic and opioid combinations. The addition of patient-controlled epidural analgesia and innovations using new technologies enhance patient satisfaction.

show abstract

Section: Discussionmentioning

confidence: 96%

Cervicographic progress in active Phase and obstetric outcome in Patients undergoing labour under Epidural analgesia

Goel¹

2017

int.jour.sci.res.mana

View full text Add to dashboard Cite

show abstract

“…Pagrin diniai būdai yra farmakologiniai -epidurinė ne jautra, intraveniniai narkotiniai analgetikai; vis labiau populiarėja ir nefarmakologiniai -natūra lieji -būdai: akupunktūra, masažas, vanduo (5). Vis dėlto auksiniu standartu pasaulyje yra pri pažinta epidurinė nejautra, ji taikoma daugiau nei 40 metų (6). Šis metodas 95 % atvejų veiksmingai ir greitai slopina gimdymo skausmus.…”

Section: įVadasunclassified

“…Mes tyrėme tik su epi durinės nejautros atlikimu susijusį skausmą, tačiau neįtraukėme skausmo, kurį galimai sukėlė akušerinių instrumentų naudojimas gimdymo metu. Taip pat minimi nepageidaujami poveikiai yra karščiavimas ir nugaros skausmas (6). Mūsų tyrime nepageidaujamų poveikių pasireiškimas abiejose grupėse statistiškai reikšmingai nesiskyrė.…”

Section: Diskusijaunclassified

See 1 more Smart Citation

Epidurinis skausmo malšinimas akušerijoje: gimdyvių savijauta, informacijos šaltiniai ir noras kito gimdymo metu keisti analgezijos būdą

Bašarinaitė¹,

Bučaitė²,

Kontrimavičiūtė³

et al. 2015

AML

View full text Add to dashboard Cite

4 Vilniaus universiteto Akušerijos ir ginekologijos klinikaDarbo tikslas. Išsiaiškinti epidurinės nejautros įtaką moterų savijautai per gimdymą ir pirmosiomis dienomis po gimdymo, ištirti, kiek moterų baimės jausmas ir informuotumas lemia jų pasirinkimą dėl skausmo malšinimo gimdymo metu. Įvertinti moterų atsiliepimus apie ligoninę.Darbo metodika. Atlikta anketinė apklausa moterų, gimdžiusių 2013 12-2014 03 VULSK Akušerijos ir ginekologijos skyriuje. Apklausta 100 gimdyvių: 41 taikyta epidurinė nejautra (I grupė -tiriamoji), o 59 -in traveninis skausmo malšinimas fentaniliu (II grupė -kontrolinė). Atrink tos moterys, gimdžiusios be Cezario pjūvio operacijos, sutikusios dalyvauti tyrime. Surinkti duomenys: apie gimdyvių amžių; gyvenamąją vietą; gim dymų skaičių; baimės jausmo stiprumą prieš gimdymą; moterų apsispren dimą dėl skausmo malšinimo, norą gauti epidurinį skausmo malšinimą; skausmo intensyvumą gimdymo metu; savijautą po gimdymo; nepagei daujamus poveikius; gimdymo skausmo malšinimo informacijos šaltinius; norą keisti analgezijos būdą kito gimdymo metu; atsiliepimai apie gimdy mo procesą ir skausmo malšinimą.Rezultatai. Respondenčių amžius -17-41 metai (vidurkis 29 ± 4,4). I grupės 37 (90,24 %) gimdyvės gyvena mieste, 4 (9,76 %) kaimo vietovėje, II -30 (51 %) mieste, 29 (49 %) kaimo vietovėje. Pirmą kartą gimdančių mo terų I grupėse buvo 56 %, II -37,3 %, p = 0,049. Gauti statistiškai reikšmingi skirtumai tarp skausmo intensyvumo vidurkių I ir II grupėse -6,71 ± 2,61 ir 8,83 ± 1,45 (p = 0,0001); savijautos po gimdymo I grupės moterų vidur kiai: 8,39 ± 1,99 balų, II -7,05 ± 2,34 (p = 0,0001). Statistiškai reikšmingai skiriasi baimės jausmas prieš gimdymą: I ir II grupių vidurkiai -6,46 ± 3,87 ir 4,30 ± 3,75 (p = 0,0093). I grupėje 65,88 %, o II grupėje 67,81 % mote rų nepasireiš kė nepageidaujamų poveikių. 60,8 % I grupės moterų buvo apsisprendu sios rinktis epidurinę nejautrą. Iš II grupės 62,7 % nebuvo apsisprendu sios. 90,24 % I grupėje domėjosi skausmo malšinimo būdais, II grupėje -61,02 % moterų nesidomėjo. Pagrindinis informacijos šalti nis -internetas (51,1 % I grupėje ir 22,04 % II grupėje). 35 (85,36 %) I gru pės ir 37 (62,71 %) II grupės moterys kito gimdymo metu nekeistų skausmo malšinimo būdo (p = 0,0005).Išvados. Taikant epidurinį skausmo malšinimą gimdymo metu sta tistiškai reikšmingai sumažėja gimdymo skausmas, pagerėja moterų sa vijauta po gimdymo, palyginti su skausmo malšinimu fentaniliu. Nepa geidaujamų poveikių pasireiškimo skirtumas statistiškai nereikšmingas. Epidurinę nejautrą dažniau renkasi gimdymo skausmo labai bijančios, pir mą kartą gimdančios, mieste gyvenančios gimdyvės, jos dažniausiai ir buvo 16 Anastasija Bašarinaitė, Aušra Bučaitė, Eglė Kontrimavičiūtė, Jūratė Šipylaitė, Diana Ramašauskaitė apsisprendusios dėl epidurinio skausmo malšinimo. Dauguma pasirinku siųjų epidurinę nejautrą apie skausmo malšinimą informacijos ieškojo in ternete ir analgezijos būdo nekeistų. Moterys, gimdžiusios su epidurine nejautra, yra labiau patenkintos gimdymu ir visu aptarnaujančiu personal...

show abstract

“…Blocking of sympathetic nerves occurs at varying concentrations and associated with vasodilatation and hypotension as well. 1 We have restricted the preload before epidural catherisation in anaemic subjects but have not withheld preload completely, as preload if not given can lead to hypotension and at the same time, excess preload can precipitate congestive cardiac failure in severely anaemic subjects.…”

Section: Introductionmentioning

confidence: 99%

To study the role of epidural analgesia in anaemic parturients

Chaudhary

Singh

Pandey

et al. 2016

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: To study the safety of epidural analgesia, effect on cardiotocographic parameters, fetal outcome and obstetric outcome of epidural analgesia in anaemic parturients and maternal satisfaction as well as pain relief among antenatal cases admitted in Upper India Sugar Exchange, GSVM Medical College, Kanpur, UP, India. Methods: This prospective study was conducted in anaemic parturients with cephalic presentation, singleton pregnancy having 36-42 weeks of gestation. Subjects of present study were divided into 2 groups. Control group included anaemic parturients not undergoing epidural analgesia. Study group included anaemic parturients who will be undergoing epidural analgesia. All these patients were followed up to delivery. When cervix was 3cm dilated, NST was taken 15minutes before analgesia and every 30 minutes after analgesia. Top up dose (0.0625% bupivacaine) was injected through catheter on parturients demand. For effect on CTG parameters, NST was taken 15minutes before analgesia and every 30 minutes after analgesia. Following every top up dose 10 minute monitoring for uterine contractions and effect for adequate analgesia was noted. Side effects and complaints noted at 5, 15, 30, 45, 60, 90, 120, 150 and 180 min interval. Fetal condition was also monitored and evidence of fetal distress, on clinical and/or cardiotocographic monitoring, was recorded. Patients walking duration was recorded in relation to study time from epidural insertion to delivery time. Labour was managed and mode of delivery and time of delivery was noted. Assessment of neonatal outcome was done with the help of Apgar scoring at 1 and 5minute after delivery and NICU admissions. Results: Maximum numbers of patients are lying between age groups of 18-23 and 24-29 years and are of gestational age group 37-40 weeks in both study and control group. The duration of 1st stage of labour in maximum number of primigravida patients is 5-8 hours and in multigravida it was 2-4 hours in both epidural and control group. The visual analogue scale is according to pain perceived during the course of labour and delivery by the epidural and control group. The degree of pain relief is statistically highly significant between epidural and control groups. Occurrences of maternal tachycardia are 5 times more in cases in whom epidural analgesia was not given. Conclusions: There is no statistically significant difference in the duration of 2nd stage of labour in both the groups of primigravida as well as there is no effect on the duration of second stage of labour in multigravida parturients in both the groups. Pain relief was more in the epidural group and was more satisfied after their delivery. There was no difference in effect on fetal outcome in epidural and control groups. There was no significant effect on cardiotocographic parameters except for the fact that for about 30 minutes post epidural top-up, there was fetal bradycardia which easily subsided with conservative management with left lateral position and oxygen. Maternal tachycardia...

show abstract

Epidural analgesia in labour

Cited by 26 publications

References 3 publications

Cervicographic progress in active Phase and obstetric outcome in Patients undergoing labour under Epidural analgesia

Cervicographic progress in active Phase and obstetric outcome in Patients undergoing labour under Epidural analgesia

Epidurinis skausmo malšinimas akušerijoje: gimdyvių savijauta, informacijos šaltiniai ir noras kito gimdymo metu keisti analgezijos būdą

To study the role of epidural analgesia in anaemic parturients

Contact Info

Product

Resources

About