The impact of epidural analgesia for acute pancreatitis on maternal and fetal outcome: a cohort study

Abstract

Introduction: It is anticipated that between 1 in 10, 000 and 1 in 30, 000 pregnancies will be affected by acute pancreatitis (AP). The authors wanted to evaluate the impact of epidural analgesia on maternal and fetal outcomes and its effectiveness in the pain treatment of obstetric patients with AP. Methodology: The period for this cohort research was from January 2022 to September 2022. Fifty pregnant women with AP symptoms were enrolled in the study. Conservative medical management was done using intravenous (i.v.) analgesics, including fentanyl and tramadol. Fentanyl was infused i.v. at a rate of 1 µg/kg every hour, while tramadol was bolused i.v. at 100 mg/kg every 8 h. Boluses of 10–15 ml of 0.1% ropivacaine were injected into the L1–L2 interspace at 2–3-h intervals to provide high lumbar epidural analgesia. Results: In this study, 10 patients were given an i.v. infusion of fentanyl, and 20 patients were given tramadol boluses. Epidural analgesia showed the most promising results decreasing the visual analog scale score from 9 to 2 in half of the patients. Most fetal complications were noticed in the tramadol group, including prematurity, respiratory distress, and babies requiring noninvasive ventilation. Conclusion: Patients with AP during pregnancy may benefit from a new technique for simultaneous analgesia during labor and cesarean section administered via a single catheter. When AP is detected and treated during pregnancy, the mother and child benefit from pain control and recovery.

Acute Pancreatitis (AP) in Pregnancy and Its Complications From an Anesthesia Perspective: A Case Report

“…Their findings showed that epidural anesthesia was better compared to intravenous anesthesia in terms of pain management and recovery of patients. Similar findings were shared by Khan et al [28] in support of the efficacy of epidural anesthesia; however, they also reported some fetal complications, including prematurity, respiratory distress, and babies requiring noninvasive ventilation in patients treated with tramadol. However, Pandey et al [29] propagated that general anesthesia could provide better hemodynamic stability in the presence of sepsis, during the use of anticoagulants such as heparin or epoprostenol for continuous venovenous hemofiltration (CVVH), and when there is a potential need for controlled postoperative ventilation.…”