Effects of combined spinal–epidural analgesia on first stage of labor: a cohort study

Poma, Silvia; Scudeller, Luigia; Verga, Chiara; Mirabile, Giorgio; Gardella, Barbara; Broglia, Federica; Ciceri, Maria; Fuardo, Marinella; Pellicori, Stefania; Gerletti, Maddalena; Zizzi, Silvia; Masserini, Elena; Delmonte, Maria Paola; Iotti, Giorgio

doi:10.1080/14767058.2018.1467892

Cited by 21 publications

(15 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, the combination of the above two anesthesia methods, namely combined spinal-epidural analgesia, has received increasing attention in recent years. 12,13 Relevant data show that combined spinal-epidural analgesia has the advantages of fast onset, perfect block, good controllability, small dosage, rapid onset of analgesia, less complications; and the anesthesia block time can be extended based on surgical needs, etc. 14,15 In the combined spinal-epidural analgesia of this study, the ropivacaine hydrochloride used is a common clinical analgesic agent, which only blocks the sensory conduction and has almost no effect on motor conduction.…”

Section: Discussionmentioning

confidence: 99%

Small-Dose Ropivacaine Hydrochloride with Fentanyl versus Large-Dose of Ropivacaine Hydrochloride for Cesarean Section

Huang

Liu

Ding

et al. 2019

J Coll Physicians Surg Pak

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Small-Dose Ropivacaine Hydrochloride with Fentanyl versus Large-Dose of Ropivacaine Hydrochloride for Cesarean Section

Huang

Liu

Ding

et al. 2019

J Coll Physicians Surg Pak

View full text Add to dashboard Cite

show abstract

“…Because of concerns regarding prolongation of the labor process [12] or reduction of uterine contractility [13], epidural puncture and catheterization were performed at our institution for parturients in need of epidural analgesia for pain relief only when the cervical dilation was approximately 2-3 cm. Parturients often feel a certain degree of pain at this point and wish to relieve it as soon as possible.…”

Section: Discussionmentioning

confidence: 99%

Real-time ultrasound-guided vs. anatomical landmark-guided paramedian epidural anesthesia in overweight parturients undergoing analgesic labor: a randomized controlled trial

2021

View full text Add to dashboard Cite

We evaluated whether real-time ultrasound-guided epidural block is more suitable for overweight parturients undergoing analgesic labor than traditional palpation positioning. Sixty overweight at-term pregnant women (body mass index ≥30 kg/m2) with singleton pregnancy, prepared for vaginal delivery with epidural analgesia, were randomly allocated into two groups. The parturients in the anatomical landmark catheterization group received paramedian epidural anesthesia using the anatomical landmark-guided technique, while real-time ultrasound-guided positioning was performed in the ultrasound-guided-catheterization group. Total procedure duration, time to identify the puncture site and perform the puncture, first attempt success rate, number of attempts, number of needle-redirections, intervertebral-space-change rate, satisfaction score, and complications were compared between the groups. Procedure duration and time to identify the puncture site were significantly shorter in the anatomical landmark catheterization group (440.1 ± 97.2 s vs. 521.9 ± 68.4 s, p < 0.001 and 24.9 ± 13.6 s vs. 112.2 ± 15.6 s, p < 0.001, respectively). There was no significant difference in the time to perform the puncture (385.3 ± 89.7 s vs. 365.1 ± 73.0 s, p = 0.341). The first attempt success rate was lower while the number of attempts and number of needle-redirections were higher in the anatomical landmark catheterization group (p < 0.05). The intervertebral-space-change rate was similar across the groups. Satisfaction was significantly lower in the ultrasound-guided catheterization group (p = 0.009). Complication occurrence, e.g., catheterization difficulty or bleeding during catheterization, dural puncture, and lower-back pain, was similar across the groups. Real-time ultrasound-guided paramedian epidural anesthesia improved the first attempt success rate and reduced the number of attempts and number of needle-redirections in overweight parturients undergoing analgesic labor. However, the longer total procedure duration and time to identify the puncture site might dissatisfy parturients.

show abstract

“…As expected, levobupivacaine consumption was significantly higher in the epidural group; but neonatal Apgar scores did not differ between groups. [ 32 ] On the other hand, the harmful effects of local anesthetics cannot be totally excluded. For example, in an early study, parturient women randomly received epidural analgesia with either sufentanil, combined sufentanil-bupivacaine, or bupivacaine alone.…”

Section: Ela Anesthetic Exposure and Neonatal Depressionmentioning

confidence: 99%

Potential impact of epidural labor analgesia on the outcomes of neonates and children

Liu

Wang

2020

Chinese Medical Journal

View full text Add to dashboard Cite

This review summarizes recent evidences regarding the potential influences of epidural labor analgesia (ELA) on the outcomes of neonates and children. Terms and relevant words including “ELA,” “ELA and neonatal outcomes,” “ELA and children's development,” and “ELA and children's neurocognitive development” were used to search articles published in PubMed database up to October 2019. Original articles and reviews regarding potential influences of ELA on neonates and children were identified. Relevant references of the selected articles were also screened. The anesthetics used during ELA can be absorbed, enter the fetus, and produce neonatal depression; however, these effects are less severe than those during systematic opioid analgesia. The impact of anesthetic exposure during ELA on children's neurodevelopment has not been fully studied, but would be mild if any. ELA increases the risk of intrapartum maternal fever; the latter may be harmful to neonatal outcomes. The use of ELA may increase birth injury by increasing instrumental delivery, although long-term adverse events are rare. On the other hand, ELA may reduce maternal depression and, thus, produce favorable effects on neurocognitive development in childhood; but evidences are still lacking in this aspect. ELA may produce both favorable and unfavorable effects on neonates and children. These effects should be discussed with parturient women before making decisions. The potential harmful effects should be carefully managed. The overall impacts of ELA on neonatal and children's outcomes need to be studied further.

show abstract

Effects of combined spinal–epidural analgesia on first stage of labor: a cohort study

Cited by 21 publications

References 18 publications

Small-Dose Ropivacaine Hydrochloride with Fentanyl versus Large-Dose of Ropivacaine Hydrochloride for Cesarean Section

Small-Dose Ropivacaine Hydrochloride with Fentanyl versus Large-Dose of Ropivacaine Hydrochloride for Cesarean Section

Real-time ultrasound-guided vs. anatomical landmark-guided paramedian epidural anesthesia in overweight parturients undergoing analgesic labor: a randomized controlled trial

Potential impact of epidural labor analgesia on the outcomes of neonates and children

Contact Info

Product

Resources

About