Outcomes of labor epidural analgesia among women aged over 40: A single‐institution retrospective study

Okazaki, Atsuyuki; Fukushima, Risa; Nagashima, Sayuri; Mazda, Yusuke; Tamura, Kazumi; Terui, Keita; Tanaka, Motoshi

doi:10.1111/jog.13109

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…The PH and mean of PCO2 and HCO3 were the same in both groups. Also, the incidence of CS in the EA group increased compared to the control group (13). The results of mentioned study are in direct agreement with our study, because in our study, the incidence of caesarean section in the epidural analgesia group was higher than that of spinal analgesia.…”

Section: Discussionsupporting

confidence: 92%

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Prevalence of Cesarean Section and Analysis of Neonatal Apgar Score and the Mean Time of Second Phase of Labor in Pregnant Women

et al. 2019

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Introduction: The labor pain is probably the most severe pain a mother experiences in her lifetime and is usually severe and prolonged in women with pregnancy, Aim: To evaluate the effects of labor epidural and spinal analgesia on the incidence of cesarean section in painless delivery. Methods: This randomized clinical trial was conducted on pregnant women aged 37-42 weeks of pregnancy. Female candidates for painless labor were divided into two groups: Epidural Analgesia (EA) and Spinal Analgesia (SA). Patients in the labor epidural group underwent analgesia using marcaine and fentanyl and after fully assuring the normal hemodynamic status of the mother and fetal hearth rate (FHR), labor spinal analgesia was used for other group. Results: The average age of mothers was 27.5 years, their mean gestational age was 39 weeks and their mean weight was determined to be 72 kg. Frequency of cesarean delivery in mothers was found as 12.9%. Significantly, the incidence of cesarean section in the labor epidural analgesia group was higher than the labor spinal analgesia group (P = 0.02). In addition, the mean second phase of delivery in the labor epidural analgesia group was significantly higher than the labor spinal analgesia group (P = 0.03). There was no significant in 1st and 5th min Apgar scores between groups in infants (8.6 and 9.6, respectively). Conclusion: Labor epidural analgesia and labor spinal analgesia result in a significant reduction in pain due to normal delivery. Due to the similarity of Apgar and arterial blood gas (ABG) in neonates, labor epidural analgesia may serve as an alternative in childbirth delivery.

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Section: Discussionsupporting

confidence: 92%

“…Okazaki and colleagues conducted a retrospective study to evaluate the effects of labor epidural analgesia on maternal and neonatal outcomes and found that the ABG parameters were not different between all groups (≥40 with labor epidural analgesia group; ≥40 without LEA group; <40 with LEA group) (13).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Cesarean Section and Analysis of Neonatal Apgar Score and the Mean Time of Second Phase of Labor in Pregnant Women

et al. 2019

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“…Several studies have reported that the incidence of operative delivery with intrapartum epidural analgesia was higher than that with no epidural analgesia . We did not study the difference between intrapartum epidural analgesia and no epidural analgesia.…”

Section: Discussionmentioning

confidence: 93%

“…The rate of pregnant women who request epidural analgesia during labor has been increasing annualy . In Japan, pregnant women's requests for intrapartum epidural analgesia have been increasing at a rate similar to that in other countries, as the number of older pregnant women (especially those over 40 years of age) has been rising …”

Section: Introductionmentioning

confidence: 99%

Perinatal outcome of vaginal delivery with epidural analgesia initiated at the early or late phase of labor period: A retrospective cohort study in the Japanese population

Shiro

Nakahata

Minami

et al. 2018

J of Obstet and Gynaecol

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“…Epidural anesthesia and analgesia are commonly used for obstetric anesthesia. Epidural anesthesia is safe for use in cesarean sections, even in patients with cardiac diseases and severe pulmonary hypertension [4,7,[10][11][12][13][14][15][16]. Several methods, including wound infiltration with a local anesthetic and magnesium sulphate, wound infiltration with tramadol and levobupivacaine, a magnesium sulphate infusion for preemptive analgesia, a transverse abdominal plane block (TAPB) performed by adding dexamethasone to levobupivacaine, infiltration by placing a continuous catheter for a TAPB or the wound area, the administration of intrathecal and intravenous betamethasone, and the addition of dexmedetomidine to increase the efficacy of epidural anesthesia and analgesia have all been used to treat pain after a cesarean section [17][18][19][20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Effects of different epidural initiation volumes on postoperative analgesia in cesarean section

et al. 2020

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This study was conducted after obtaining Ethics Committee approval from the İnönü University Medical Faculty (2015/171) and informed consent from all of the Background/aim: The aim of this study was to compare the effects of different epidural initiation volumes on postoperative pain scores, analgesic requirements, and side effects in pregnant women administered patient-controlled epidural analgesia (PCEA) for postoperative pain after cesarean sections.Materials and methods: Eighty-one pregnant women, aged 18-45 years, were included in this randomized, double-blind study. Combined spinal epidural anesthesia was administered for each cesarean section. The patients were divided into 3 groups and different volumes (20 mL, 10 mL, and 5 mL) of the study drug (0.0625% bupivacaine plus 2 μg/mL of fentanyl) were administered 90 min after the spinal block via epidural catheter. The visual analogue scale (VAS) scores at rest and during movement, first PCEA dose time, number of PCEA doses required per hour, total analgesic consumed, and side effects were recorded postoperatively.Results: There were no statistically significant differences among the groups in terms of the VAS rest and VAS movement scores. The times to the first analgesic dose requirement were longer in Group 10 and Group 20 than in Group 5. The analgesic requirement during the first 2 h was lower in Group 20 than in the other groups. Conclusions: The PCEA initiations with different volumes provided similar pain scores. However, the 20 mL volume resulted in a lower analgesic dose requirement during the early postoperative period, and it also delayed the requirement for analgesia.

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Outcomes of labor epidural analgesia among women aged over 40: A single‐institution retrospective study

Abstract: Our study showed that parturients aged ≥40 with LEA can expect similar LEA-associated labor outcomes to younger parturients with LEA.

Cited by 7 publications

References 16 publications

Prevalence of Cesarean Section and Analysis of Neonatal Apgar Score and the Mean Time of Second Phase of Labor in Pregnant Women

Prevalence of Cesarean Section and Analysis of Neonatal Apgar Score and the Mean Time of Second Phase of Labor in Pregnant Women

Perinatal outcome of vaginal delivery with epidural analgesia initiated at the early or late phase of labor period: A retrospective cohort study in the Japanese population

Effects of different epidural initiation volumes on postoperative analgesia in cesarean section

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