Maternal and fetal outcome in epidural analgesia study

Choudhary, Jaya; Sharma, Himanshu; Agrawal, Vishal

doi:10.18203/2320-1770.ijrcog20163441

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…14 Many studies prove that epidural analgesia leads to the prolongation of first and second stage of labour as it results in suppression of prostaglandin F2α release, leading to diminished uterine contractility and thus requiring oxytocin augmentation to keep the average labour duration. 11,15 In the current study requirement of oxytocin augmentation was more in epidural group as compared to control group, but we failed to show significant association between epidural analgesia and the number of patients who required oxytocin augmentation during labor. This can be explained by a careful use of oxytocin infusion to negate the possible effect of epidural analgesia on the course of labor.…”

Section: Discussioncontrasting

confidence: 64%

Effect of epidural analgesia on the duration of labour and pains: a comparative study

Chauhan

Shirodkar

2020

Int J Reprod Contracept Obstet Gynecol

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Background: Epidural analgesia is regional anaesthesia that blocks pain in a particular region of the body. The use of Epidural Analgesia (EA) in labor is widespread in modern labor ward practice, and its benefits in terms of pain relief are well-recognized. Objective of this study was to study the effect of epidural analgesia on the duration of labour and pains.Methods: The present study was conducted on 60 women in the department of obstetrics and gynecology at Topiwala National Medical College, Mumbai during a period from October 2014 to January 2017. The women requesting EA were assigned as the study group (Group A - 30 cases) and women not receiving EA were included in the control group (Group B - 30 cases).Results: The duration of active phase of first and second stage of labour was found to be prolonged in patients who received EA as compared to control group. An increase in number of caesarean sections and requirement of oxytocin augmentation was found to be more in Group A as compared to Group B. There was no statistically significant difference in Apgar score of newborns at 1 min and 5 min in both the groups. The patients demanding epidural drug had better pain relief during labour. In Group A, 17% of patients and in Group B, 7% of patients had nausea and vomiting. Other side effects were minimal.Conclusions: Epidural analgesia is not a totally free of disadvantages, it is the most effective mode of pain relief available compared with other techniques. The addition of patient-controlled epidural analgesia and innovations using new technologies enhance patient satisfaction.

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Section: Discussioncontrasting

confidence: 64%

Effect of epidural analgesia on the duration of labour and pains: a comparative study

Chauhan

Shirodkar

2020

Int J Reprod Contracept Obstet Gynecol

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“…Hence asserting the point that epidural analgesia has no difference in the neonatal outcome as compared to the control group by comparing the APGAR scores at 1 and 5 minutes. 14 In the present study the foetal heart rate during the process of labour analgesia was within normal limits. There was no incidence of post epidural foetal bradycardia.…”

Section: Foetal and Neonatal Outcomesupporting

confidence: 58%

A Comparative Study of 0.125% Ropivacaine With Fentanyl 2 McG/Ml Versus 0.125% Bupivacaine With Fentanyl 2mcg/Ml for Labour Epidural Analgesia

Balasubramanyam¹,

Jamuna²,

Reddy³

2018

jebmh

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BACKGROUNDThis study was undertaken to determine whether epidural analgesia is superior to all methods of pain relief for labour. Previous studies compared different concentrations of local anaesthetics epidurally with or without additives. Here ropivacaine is compared because, it is a new long acting amide local anaesthetic agent which is less lipophilic than bupivacaine and is less likely to penetrate large myelinated motor fibres, resulting in relatively reduced motor blockade. The reduced lipophilicity is associated with decreased potential of central nervous system toxicity and cardiotoxicity. Because of its favourable pharmacokinetic profile, the ropivacaine is chosen for labour epidural in comparison with bupivacaine. Aims and Objectives-to compare smaller concentration of epidural ropivacaine with bupivacaine in intermittent doses for obstetric analgesia by adding fentanyl to ropivacaine and bupivacaine solutions.

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Comparison of ropivacaine (0.2%) and ropivacaine (0.125%) with 2 μg/ml fentanyl for epidural labor analgesia

Rapeti,

Mulam,

Sowbhagya Lakshmi

et al. 2021

The Indian Anaesthetists Forum

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Aim: The aim of this study was to determine the minimum effective local anesthetic concentration required to provide good analgesia with less consumption of opioids. Objective: Among various labor analgesic techniques, epidural analgesia is the most effective form of analgesia. This study aimed to determine the minimum effective local anesthetic concentration required to provide good analgesia with less consumption of opioids. The objective of this study was to evaluate the efficacy of 0.125% and 0.2% ropivacaine, both with fentanyl 2 μg/ml for epidural labor analgesia. Materials and Methods: A total of 50 term parturients of American Society of Anesthesiologists physical status Grade I and II with vertex presentation in active labor were randomly assigned to two groups, Group R1 and Group R2, which received 10 ml of 0.125% ropivacaine with injection fentanyl 2 μg/ml and 10 ml of 0.2% ropivacaine with fentanyl 2 μg/ml, respectively, as an initial bolus dose and intermittent top-up doses epidurally. Characteristics of the block, onset and duration of analgesia, and total analgesic requirements were noted. Pain and overall satisfaction scores were assessed with the Visual Analog Scale score. The maternal and fetal outcomes were recorded. Results: Maternal demographic characteristics were comparable. Although both the concentrations are effective in providing optimal labor analgesia, decreasing the concentration of ropivacaine has resulted in an increased number of repetition of doses and thus an increased consumption of fentanyl. There were no significant differences between the two groups regarding motor block, hemodynamic, and neonatal outcomes. Conclusion: We conclude that 0.2% ropivacaine was found superior in terms of faster onset, prolonged duration, lesser breakthrough pain requiring lesser top-ups, and hence a lesser consumption of opioids. Hence, we conclude that the use of 0.2% ropivacaine is superior to 0.125% ropivacaine with fentanyl.

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Maternal and fetal outcome in epidural analgesia study

Cited by 4 publications

References 6 publications

Effect of epidural analgesia on the duration of labour and pains: a comparative study

Effect of epidural analgesia on the duration of labour and pains: a comparative study

A Comparative Study of 0.125% Ropivacaine With Fentanyl 2 McG/Ml Versus 0.125% Bupivacaine With Fentanyl 2mcg/Ml for Labour Epidural Analgesia

Comparison of ropivacaine (0.2%) and ropivacaine (0.125%) with 2 μg/ml fentanyl for epidural labor analgesia

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