Serious complications associated with epidural/spinal blockade in obstetrics: a two-year prospective study

Scott, D.B.; Tunstall, M.E.

doi:10.1016/0959-289x(95)82967-f

Cited by 112 publications

(44 citation statements)

References 3 publications

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“…The fall of blood pressure in epidural group was slow, not rapid. This was also found in the study of Scott 8 . No abrupt change of heart rate was observed in either groups.…”

Section: Discussionsupporting

confidence: 74%

“…The proportion was more in spinal anesthesia where the fall was rapid and marked, which was treated with vasopressor and/ or additional intravenous fluid to maintain optimum level of blood pressure. This is comparison to the study done by Scott in 1995 8 .…”

Section: Discussionmentioning

confidence: 98%

“…Although the incidence of hypotension is not infrequent in epidural technique but it occurs earlier and more rapidly with the spinal approach. Hypotension lowers maternal mean arterial pressure (MAP) and uteroplacental perfusion 8 .…”

Section: Discussionmentioning

confidence: 99%

“…The epidural technique was the regional anesthesia of choice for cesarean section in North America in 1992, but this popularity had changed from epidural to spinal anesthesia by 1997 7 . In UK, spinal anesthesia has been a preferred technique in the last decade 8 . In a recent hospital survey (total 37,000 births a year) in the South-West Thames region of the UK, the rate of regional anesthesia for elective cesarean section was 94.9%, with spinal anesthesia being used in 86.6% of these cases 9 .…”

Section: Original Articlementioning

confidence: 99%

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Comparative study between lumbar epidural and spinal anaesthesia in elective caesarean section: comparison of maternal status during operation and in the post operative period

Hossain

Habib²,

Kamal

et al. 2009

j Bangladesh Soc Anaesthesiologists

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The caesarean section (C/S) is preferably done under regional techniques like spinal and epidural anesthesia. Both these techniques are also preferable to general anaesthesia which allows the mother to remain awake during caesarean delivery. After the approval of the institutional ethical committee, sixty (60) patients were equally divided into group-I (Spinal group) and ‘group-II (Epidural group). The intraoperative hemodynamic parameters (blood pressure & heart rate) and any event like nausea, vomiting, discomfort, shivering and the overall maternal satisfaction were compared between the groups. During post operative period mothers were interviewed for pain relief and choice of anesthetic technique. The mothers were also interviewed regarding their experiences of present anesthetic technique in comparison to the previous experiences. All data were analyzed statistically. The epidural group is significantly superior to spinal group in maternal satisfaction, frequency & magnitude of hypotension and postoperative pain relief. The hypotension that was needed to be treated with vasopressor was significantly different between the two groups (Spinal 33.33%, Epidural 10.00%, P<0.05). There is no significant difference between the groups regarding the analgesic requirement. The mothers of epidural group had chosen the technique and recommended this as the ideal technique for elective CS. But the time taken to start operation after the epidural anaesthesia was longer than spinal technique. The prolong onset to start the operation is an opportunity to make rapport between the mother and the anesthesiologist. Journal of BSA, 2008; 21(2): 61-66

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“…The fall of blood pressure in epidural group was slow, not rapid. This was also found in the study of Scott 8 . No abrupt change of heart rate was observed in either groups.…”

Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

See 2 more Smart Citations

Comparative study between lumbar epidural and spinal anaesthesia in elective caesarean section: comparison of maternal status during operation and in the post operative period

Hossain

Habib²,

Kamal

et al. 2009

j Bangladesh Soc Anaesthesiologists

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show abstract

“…Retrospective [12,13] and prospective [1,[14][15][16][17][18] studies indicate that extradural analgesia is an effective, reliable and safe technique for pain relief during labour and delivery when provided by qualified and skilled personnel. As parturients are more satisfied with extradural analgesia than with other types of labour pain relief, e.g.…”

Section: Discussionmentioning

confidence: 99%

Initiating Extradural Analgesia during Labour: Comparison of Three Different Bupivacaine Concentrations Used as the Loading Dose

Harms

Siegemund²,

Marsch³

et al. 1999

Fetal Diagn Ther

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Objective: Potential effects of extradural analgesia on the progress of labour and obstetric outcome are still a matter of concern and the focus of ongoing debates. Despite this, little attention is paid to the initiation of extradural labour analgesia. The objective of this prospective, randomized, double-blind trial was to identify the optimal of three concentrations of bupivacaine used as a loading bolus for initiating extradural analgesia during labour. Methods: Sixty-seven full-term parturients requesting extradural analgesia received either bupivacaine 0.25% (group A), 0.125% (group B) or 0.0625% (group C). Bupivacaine administration was titrated to achieve a pain score ≤1.5 on a 10-cm visual analogue scale (VAS) and was limited to a maximum of 20 ml of the study drug. We recorded the time to achieve a VAS ≤1.5, the total amount of local anaesthetic used, sensory level, maternal and foetal as well as neonatal side effects. Results: The probability of obtaining a VAS pain score ≤1.5 was significantly lower in group C. Although mean times to reach a VAS pain score ≤1.5 were not statistically different, survival curves show a significantly lower probability for reaching this score. Significantly more parturients in group A developed a motor block ≥1 based on using a modified Bromage scoring scale. There were no differences in incidence of maternal hypotension, ephedrine requirements, foetal heart rate abnormalities, mode of delivery and neonatal outcome. Conclusions: Of the three concentrations used in this clinical setting, 0.125% was the most suitable concentration of plain bupivacaine to initiate extradural analgesia in labour. Using 0.25% bupivacaine increased the incidence of motor block, whereas for 0.0625% plain bupivacaine the probability to achieve adequate analgesia was unacceptably low.

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Epidural versus non-epidural analgesia for pain relief in labour

Howell

1999

Cochrane Database of Systematic Reviews

153

130

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Serious complications associated with epidural/spinal blockade in obstetrics: a two-year prospective study

Cited by 112 publications

References 3 publications

Comparative study between lumbar epidural and spinal anaesthesia in elective caesarean section: comparison of maternal status during operation and in the post operative period

Comparative study between lumbar epidural and spinal anaesthesia in elective caesarean section: comparison of maternal status during operation and in the post operative period

Initiating Extradural Analgesia during Labour: Comparison of Three Different Bupivacaine Concentrations Used as the Loading Dose

Epidural versus non-epidural analgesia for pain relief in labour

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