Prior lumbar discectomy surgery does not alter the efficacy of neuraxial labor analgesia

Anesthesia and Analgesia
Jeanette R BauchatCynthia A Wong

Abstract

Lumbar discectomy surgery is a common neurosurgical procedure. Neuraxial labor analgesia may be less effective in parturients with a history of discectomy surgery because of postsurgical scarring and anatomical distortion. In this prospective observational case-controlled study, we compared bupivacaine consumption per hour of labor analgesia as an indirect measure of labor analgesic effectiveness between women with prior discectomy surgery and those who did not have back surgery. All women with prior discectomy surgery who requested neuraxial labor analgesia at a high-volume, single university-affiliated women's hospital during the study period were approached. Control subjects were matched for anesthesiologist skill level. The primary outcome was bupivacaine consumption per hour of labor analgesia. Characteristics associated with the epidural catheter placement including the number of interspaces attempted, time to placement, and number of epidural catheters replaced for inadequate analgesia were recorded. Subject characteristics, labor outcomes, and analgesia outcomes were analyzed using the Wilcoxon ranked sum or Fisher exact test. Epidural placement data were analyzed using the Wilcoxon signed rank, McNemar's, or sign test....Continue Reading

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Citations

Aug 6, 2013·Genetic Testing and Molecular Biomarkers·Zheming SongXueyin Shi
Nov 12, 2013·International Journal of Obstetric Anesthesia·A Palanisamy
May 20, 2016·Anesthesia and Analgesia·Honorio T BenzonCraig T Hartrick

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