Lumbar epidural analgesia in labour: a 24-hour service provided by obstetricians.

Taylor, Anne; Abukhalil, S. H.; El-Guindi, M. M.; Tharian, B.; Watkins, J. A.

doi:10.1136/bmj.2.6083.371

BMJ

1977

DOI: 10.1136/bmj.2.6083.371

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Lumbar epidural analgesia in labour: a 24-hour service provided by obstetricians.

Anne Taylor¹,

S. H. Abukhalil²,

M. M. El-Guindi³

et al.

Abstract: SummaryOf 309 consecutive cases of epidural analgesia provided by obstetricians, 250 were set up by junior obstetric staff. Midwives managed the epidural analgesia and gave the top-up doses as part of their traditional role in providing pain relief in labour. This practice was thought to be influential in producing a high spontaneous delivery rate. With specialised training and clinical integration the benefits of an epidural analgesic service can safely be provided by obstetricians in a small maternity hospit… Show more

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1980

1981

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“…Epidural and paracervical block have been used increasingly in recent years for pain relief in parturients during delivery (1)(2)(3)(4). Different effects of these methods on the parturient, fetus and child, both beneficial and adverse, have been described (2, 5 , cf.…”

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confidence: 98%

METABOLIC EFFECTS OF OBSTETRIC REGIONAL ANALGESIA AND OF ASPHYXIA IN THE NEWBORN INFANT DURING THE FIRST TWO HOURS AFTER BIRTH: I. Arterial Blood Glucose Concentrations

Swanström

Bratteby

1981

Acta Paediatrica

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Effects of obstetric regional analgesia and of asphyxia on the arterial blood glucose concentrations were investigated in 83 newborn infants divided into a control group, an asphyxia group, a continuous epidural, and a paracervical + pudendal block group. Lidocaine was used in the analgesia groups. All infants except those of the asphyxia group had 1-minute Apgar scores greater than or equal to 7.1) In the asphyxiated infants high blood glucose values and strong correlations between blood glucose concentrations and different signs of asphyxia (Apgar score, base deficit and lactate) were found. 2) In infants whose mothers were given regional analgesia the results were: (a) high glucose values in 20% of the infants and an association between increased glucose concentrations in these infants and signs of fetal distress, (b) low blood glucose values (less than 1.67 mmol/l) in 27% of the infants. It is recommended that the blood glucose is checked in the newborns after obstetric regional analgesia.

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mentioning

confidence: 98%

METABOLIC EFFECTS OF OBSTETRIC REGIONAL ANALGESIA AND OF ASPHYXIA IN THE NEWBORN INFANT DURING THE FIRST TWO HOURS AFTER BIRTH: I. Arterial Blood Glucose Concentrations

Swanström

Bratteby

1981

Acta Paediatrica

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An integrated pain relief service for labour: co‐operation between obstetricians, anaesthetists and midwives

Ghosh‐Ray¹,

Taylor²,

Alberts³

1980

Anaesthesia

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Summary Epidural injections were performed by obstetricians on 1012 patients in a pain relief service in which there was clinical co‐operation between anaesthetists and obstetricians. A consultant anaesthetist collaborated in the training of staff providing the service. Midwives maintained the epidural analgesia with top‐up doses as part of their traditional role in providing pain relief in labour. Eighty‐eight per cent of patients were fully satisfied, 10‰ were helped and 2‰ had failed epidurals. The forceps rate was 30‰ and the dural tap rate 1.4‰ Junior obstetric staff in training grades can with adequate safeguards make a significant contribution to running an obstetric epidural service.

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Mothers'views of Care in Labour

Kirke

1980

BJOG

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Summary The management of labour was the main focus of interest in this study of mothers' views of their obstetric care. Most of the mothers, 63 per cent, were satisfied with their care by both the doctors and midwives during labour and delivery. Those who were not satisfied rarely questioned the technical competence of the staff but were more concerned with the manner in which care was provided. Thirteen per cent stated that they were not attended by a doctor at any stage during labour or delivery and 43 per cent said they were left alone for at least five minutes; both groups of mothers were more anxious during labour and delivery and were less satisfied with their overall care than those who did not have such experiences. The mothers' feelings about the various procedures which they had during labour and delivery, including induction, were generally favourable. Although overall satisfaction with care was expressed by 77 per cent of the mothers, the findings suggest that obstetricians and midwives need to give greater consideration to the social and psychological aspects of patient care.

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Lumbar epidural analgesia in labour: a 24-hour service provided by obstetricians.

Cited by 3 publications

References 3 publications

METABOLIC EFFECTS OF OBSTETRIC REGIONAL ANALGESIA AND OF ASPHYXIA IN THE NEWBORN INFANT DURING THE FIRST TWO HOURS AFTER BIRTH: I. Arterial Blood Glucose Concentrations

METABOLIC EFFECTS OF OBSTETRIC REGIONAL ANALGESIA AND OF ASPHYXIA IN THE NEWBORN INFANT DURING THE FIRST TWO HOURS AFTER BIRTH: I. Arterial Blood Glucose Concentrations

An integrated pain relief service for labour: co‐operation between obstetricians, anaesthetists and midwives

Mothers'views of Care in Labour

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