The effects of epidural analgesia using low-concentration local anesthetic during the entire labor on maternal and neonatal outcomes: a prospective group study

Zeng, Huiqian; Guo, Fang; Lin, Bo; Liu, Lei; Wei, Wei; He, Ping; Lai, Yuxiong

doi:10.1007/s00404-020-05511-8

Cited by 17 publications

(18 citation statements)

References 8 publications

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“…This finding suggested that there should be a dose-response relationship between the concentration of epidural local anesthetics and the effect of the second stage of labor. These authors' findings are similar to recent findings that minimum local analgesic concentrations of epidural sufentanil or ropivacaine provided satisfactory and safe analgesia for parturients, while they had a low incidence rate of side effects [18,25].…”

Section: Discussionsupporting

confidence: 89%

The effect of epidural analgesia on maternal-neonatal outcomes: a retrospective study

et al. 2021

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Section: Discussionsupporting

confidence: 89%

The effect of epidural analgesia on maternal-neonatal outcomes: a retrospective study

et al. 2021

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“…Epidural analgesia was continued during the second stage of labour, and maintained for 1 day after delivery. Similar analgesia protocol was used in another research by our team which the paper had published this year [9] .…”

Section: Methodsmentioning

confidence: 99%

Effect of Intrapartum Fever Associated With Epidural Analgesia on Short-Term Maternal and Neonatal Outcomes in Nulliparous Women: A Case Control Study

Zeng¹,

Lin²,

Zhang³

et al. 2020

Preprint

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BackgroundThe effects of intrapartum fever associated with epidural analgesia in nulliparous women on the short-term maternal and neonatal outcomes are not well understood.Methods We included 2076 nulliparous women who received regular obstetric examination and gave birth at Guangzhou Women and Children’s Medical Center from January 1, 2020 to June 30, 2020. All cases were singleton full-term pregnancies, and all foetuses were in cephalic presentation. We allocated 817 women with temperature >38℃ during labour into the fever group and 1259 women with temperature ≤38℃ during labour to the non-fever group. The short-term maternal and neonatal outcomes in the two groups were compared. Results in the fever group, 8.3% of pregnant women converted to caesarean delivery. The conversion rate in the non-fever group was 5.2% (p = 0.004). The rates of mild neonatal asphyxia, severe neonatal asphyxia, and neonatal hospitalisation in the fever group were higher than those in the non-fever group (χ2 = 12.070, 6.325, and 6.821, respectively, all P<0.05). The 1194 pregnant women in the fever group who had vaginal deliveries spent 756.46 ± 256.43 minutes in the first stage of labour and 65.74 ± 47.63 minutes in the second stage, significantly longer than the 749 women who had vaginal deliveries in the non-fever group (P<0.001, P=0.001). The assisted delivery rate for vaginal delivery in the fever group was 49.0%, significantly higher than that in the non-fever group (2=49.738, P<0.001). The rates of mild neonatal asphyxia, severe neonatal asphyxia, neonatal acidosis, and neonatal hospitalisation with vaginal delivery in the fever group were higher than those in the non-fever group (2=15.375, 6.597, 22.265, and 7.322, respectively, and p<0.001, 0.010, <0.001, and 0.007, respectively).Conclusions Epidural analgesia-associated intrapartum fever in nulliparous women increased the rates of short-term adverse maternal and neonatal outcomes, indicating that efforts are needed to prevent incidence of intrapartum fever due to administration of epidural analgesia.

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“…Hal ini dapat terjadi karena obat-obatan yang diberikan pada epidural analgesia, diberikan dengan dosis yang tepat dan pemberiannya melalui rute rongga epidural pada tulang belakang sehingga obat tidak masuk kedalam intra vena serta tidak masuk kedalam sawar plasenta (Zeng et al, 2020). Tanda vital pada ibu yang dilakukan tindakan epidural analgesia seperti tekanan darah, nadi dan saturasi juga dimonitor, setiap 15 menit selama 1 jam dan pemberian resusitasi cairan baik kristaloid maupun koloid sesuai dengan kondisi ibu saat itu, sehingga Mean Arterial Pressure (MAP) ibu tetap tercukupi, sehingga tidak mempengaruhi skor APGAR menit pertama dan kelima bayi baru lahir (Sun et al, 2019).…”

Section: Pembahasanunclassified

“…Pada penelitian ini juga diperlihatkan hubungan frekuensi nadi bayi baru lahir dengan terapi farmakologi analgesia epidural pada persalinan normal dinyatakan dengan nilai p value = 0,621, hal ini membuktikan bahwa tidak ada hubungan yang signifikan antara frekuensi nadi bayi baru lahir dengan therapy analgesia epidural pada persalinan normal. Kondisi ini dapat mempengaruhi nilai APGAR Skor dimana karena obatobatan yang diberikan pada epidural analgesia, diberikan dengan dosis yang tepat dan pemberianya melalui rute rongga epidural pada tulang belakang (Zeng et al, 2020). Observasi yang ketat dengan cairan yang tepat akan membuat Mean Arterial Pressure (MAP) ibu tetap tercukupi dan hal ini kembali akan berdampak pada nutrisi dan oksigenasi ke janin tidak terganggu, sehingga tidak mempengaruhi frekuesnsi nadi bayi baru lahir (Srebnik et al, 2019).…”

Section: Pembahasanunclassified

Terapi Farmakologi Epidural Analgesia pada Persalinan Normal dengan Kestabilan Tanda Vital Bayi Baru Lahir

Purwarini¹,

Sykenario²

2022

JKS

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This study aims to determine the relationship between pharmacological therapy of epidural analgesia in normal delivery and the stability of newborns' vital signs at X Hospital Jakarta. The study used secondary data, electronic medical records, patient registration books and used quantitative methods with a cross-sectional approach. The results showed a significant relationship between temperature with p-value = 0.000 OR 5.179 (95% CI 2.684-9.992), respiratory rate with p-value = 0.027 OR 4.377 (95% CI 1.055-18.160) with and without epidural analgesia. There is no significant relationship between the first minute APGAR scores, p-value = 0.486 using the chi-square test and fifth p-value = 1,000 and pulse p-value = 0.621 using the Fishers exact test. In conclusion, epidural analgesia is safe for both mother and baby with proper monitoring. Keywords: Epidural Analgesia, Breathing Frequency, Pulse, Normal Delivery, APGAR

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The effects of epidural analgesia using low-concentration local anesthetic during the entire labor on maternal and neonatal outcomes: a prospective group study

Cited by 17 publications

References 8 publications

The effect of epidural analgesia on maternal-neonatal outcomes: a retrospective study

The effect of epidural analgesia on maternal-neonatal outcomes: a retrospective study

Effect of Intrapartum Fever Associated With Epidural Analgesia on Short-Term Maternal and Neonatal Outcomes in Nulliparous Women: A Case Control Study

Terapi Farmakologi Epidural Analgesia pada Persalinan Normal dengan Kestabilan Tanda Vital Bayi Baru Lahir

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