PMID: 11605932Oct 19, 2001Paper

Combined spinal-epidural versus epidural labor analgesia

Anesthesiology
M C NorrisC Conway-Long

Abstract

Despite the growing popularity of combined spinal-epidural analgesia in laboring women, the exact role of intrathecal opioids and the needle-through-needle technique remains to be determined. The authors hypothesized that anesthetic technique would have little effect on obstetric outcome or anesthetic complications. Data were prospectively collected from 2,183 laboring women randomly assigned to have labor analgesia induced with either 10 microg intrathecal sufentanil with or without 2.0 mg bupivacaine (n = 1,071) or 10 microg epidural sufentanil and 12.5-25.0 mg bupivacaine (n = 1,112). Immediately after induction, a continuous epidural infusion of 0.083% bupivacaine plus 0.3 microg/ml sufentanil was begun in all patients and continued until delivery. Labor was managed by nurses, obstetricians, and obstetric residents who were unaware of the anesthetic technique used. Anesthetic technique lacked impact on our primary outcome: mode of delivery or labor duration. Infants whose mothers were allocated to the combined spinal-epidural group had a slightly higher umbilical artery carbon dioxide partial pressure (54.2 +/- 10.4 vs. 53.2 +/- 10.2 mmHg). However, only achieving at least 5 cm cervical dilation before induction of analgesi...Continue Reading

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Citations

Nov 28, 2012·Journal of Anesthesia·Guilherme Holck, William Camann
Feb 26, 2004·Heart & Lung : the Journal of Critical Care·Janelle YorkeBrad McLean
Oct 8, 2003·Best Practice & Research. Clinical Anaesthesiology·Kenneth D Candido, Rom A Stevens
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