Influence of maternal position during epidural labor analgesia

Soetens, Filiep; Meeuwis, H.; Donck, A.G Van der; Vel, M.A De; Schijven, Marlies P.; Zundert, A.A. van

doi:10.1016/s0959-289x(02)00160-7

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…23 Soetens et al in a prospective randomised double blind trial compared spread and pain relief in 34 parturients in the left lateral versus 33 in a modified supine position. 24 More dermatomes were blocked on the dependent side in the left lateral position at 20 and 30 min and before the second epidural injection. The modified supine position was associated with a greater incidence of bilaterally blocked dermatomes T10-L1, a better visual analogue pain score but three cases of supine hypotensive syndrome.…”

Section: Discussionmentioning

confidence: 94%

Hip-flexed postures do not affect local anaesthetic spread following induction of epidural analgesia for labour

Ducloy-Bouthors

Davette

Fahler

et al. 2004

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 94%

Hip-flexed postures do not affect local anaesthetic spread following induction of epidural analgesia for labour

Ducloy-Bouthors

Davette

Fahler

et al. 2004

International Journal of Obstetric Anesthesia

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“…In another study in this field, it has been noted that the reversed Trendelenburg position of 10° significantly restricts the level of sensory block immediately after spinal anaesthesia and prolongs the duration of unilateral spinal anaesthesia 17 .…”

Section: Discussionmentioning

confidence: 96%

The duration of spinal anaesthesia in elective caesarean section in Trendelenburg and reverse Trendelenburg positions: a randomized clinical trial

Mashak,

Pouryaghobi,

Hashemnejad

et al. 2024

Annals of Medicine &Amp; Surgery

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Objective: One of the common methods of anesthesia for cesarean sections (CS) involves the use of spinal anesthesia in mothers. Various positions are utilized in this method. This study aims to compare the evaluation of two positions, Trendelenburg and reverse Trendelenburg, in candidates for CS to assess the duration of anesthesia and changes in vital signs in women. Methods: This study was a randomized clinical trial in which 60 pregnant mothers who met the inclusion criteria entered the study. These mothers were randomly allocated into two equal groups using block randomization. One group of patients received spinal anesthesia in the Trendelenburg position, while the other group received it in the Reverse Trendelenburg position. Vital signs (systolic and diastolic blood pressure, heart rate, Apgar score, and SPO2) of participants from both groups were evaluated for one hour after the induction of anesthesia. Additionally, sensory level and duration of anesthesia were measured. Finally, the data from both groups were subjected to statistical analysis using SPSS version 26 software. Results: The mean (SD) age of participating mothers in the Reverse Trendelenburg and Trendelenburg groups was 28.93 (5.82) and 30.97 (4.94) respectively. The two study groups did not significantly differ in baseline characteristics such as age, body mass index, which could potentially impact vital sign outcomes or anesthesia duration, and education (P>0.05). The mean (SD) duration of anesthesia in the Trendelenburg position was significantly higher than in the Reverse Trendelenburg position (221.57(min) vs. 159.00(min)) (P<0.0001). There was no significant difference between the two positions, Trendelenburg and Reverse Trendelenburg, in terms of sensory level and its extent (P=0.08). The two study groups did not significantly differ in hemodynamic changes measured 13 times, including heart rate, systolic and diastolic blood pressure, and Apgar score (P>0.05). Conclusion: In spinal anesthesia with the Trendelenburg position compared to the Reverse Trendelenburg position, there is a longer duration of anesthesia. This is while the two positions did not differ in terms of hemodynamic changes and sensory level.

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“…Dermatome T10 blocking is recognized as one of the standards for successful epidural labor analgesia. 6 , 7 Considering L2-3 space is more closer to head, which facilitates solution to reach a higher level. Thus, we hypothesized that under fix volume and injection mode, a higher puncture point may help to reach a more rapid onset of sufficient analgesia.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

Zhou,

Peng,

Chen

et al. 2023

JPR

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Purpose Parturients suffer severe pain during the stages of labor, especially the first and second. Epidural anesthesia is an effective method to alleviate labor pain. L2-3, L3-4 and L4-5 spaces have been reported to be the recommendable puncture points owing to the adequate analgesia effect and high safety. However, the speed of pain alleviation via the three points has hardly been determined, which is of great importance to parturients. Thus, the aim of this study is to compare the onset time of parturients’ painless uterine contraction after epidural labor analgesia through different puncture points. Study Design and Methods It is a prospective, randomized, controlled, and subject- and assessor-blinded study. Totally, 150 subjects scheduled for vaginal delivery are going to be randomly assigned into the L2-3 and L3-4 group. Puncture point in L2-3 group is lumbar 2–3 space, while in L3-4 group it is lumbar 3–4 space. Analgesia initiation and maintenance are the same between the two groups. Primary outcome will be percentage of painless uterine contraction 15 min after epidural labor analgesia initiation. Secondary outcomes will be the sensory blocking level, motor blocking score, adverse effects of parturients, drug liquid consumption in unit interval, apgar score and degree of satisfaction of the parturients. Discussion This study estimates the onset time of parturients’ painless uterine contraction after epidural labor analgesia through L2-3 or L3-4 space. The results may provide a better choice to relieve labor pain as soon as possible.

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Influence of maternal position during epidural labor analgesia

Cited by 6 publications

References 8 publications

Hip-flexed postures do not affect local anaesthetic spread following induction of epidural analgesia for labour

Hip-flexed postures do not affect local anaesthetic spread following induction of epidural analgesia for labour

The duration of spinal anaesthesia in elective caesarean section in Trendelenburg and reverse Trendelenburg positions: a randomized clinical trial

The Effects of Different Puncture Points on Labor Analgesia Onset: Study Protocol for a Randomized Controlled Trial

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