PMID: 9637643Jun 24, 1998Paper

Treatment of incomplete analgesia after placement of an epidural catheter and administration of local anesthetic for women in labor

Anesthesiology
Y BeilinL A Andres

Abstract

Approximately 15% of women still have pain after placement of an epidural catheter and administration of local anesthetic for labor analgesia. Two techniques frequently used to treat this pain were compared: (1) withdrawal of the catheter 1 cm and repeated dosing with additional local anesthetic, and (2) repeated dosing with additional local anesthetic without any catheter manipulation. Fifteen minutes after placement of a multiple-orifice epidural catheter 5 cm into the epidural space and administration of 13 ml 0.25% bupivacaine to the parturient in labor, the adequacy of analgesia was assessed. All women who had incomplete analgesia were randomized (first intervention) to receive an additional 5 ml 0.25% bupivacaine (local-anestheticonly group) or to receive 5 ml 0.25% bupivacaine after first withdrawing the epidural catheter 1 cm (catheter-manipulation group). If after 15 min the woman still had pain, then (second intervention) the catheter was withdrawn 1 cm and an additional 5 ml 0.25% bupivacaine was administered to the local-anesthetic-only group, whereas 5 ml 0.25% bupivacaine was given to the catheter-manipulation group without further catheter manipulation. The success rate of the second intervention was assessed 15 ...Continue Reading

Associated Clinical Trials

References

Feb 1, 1990·British Journal of Anaesthesia·L M Morrison, A S Buchan
Apr 1, 1983·British Journal of Anaesthesia·A F MerryC J Wild
Sep 1, 1981·Canadian Anaesthetists' Society Journal·S H RolbinS Virgint
Jan 1, 1996·Anesthesiology·R D'AngeloJ C Gerancher
Sep 1, 1996·Anesthesia and Analgesia·F Asato, F Goto
Jun 1, 1997·Anesthesia and Analgesia·R D'AngeloC H Livesay
Jan 1, 1996·International Journal of Obstetric Anesthesia·C B Collier

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Citations

Sep 27, 2006·Anesthesia and Analgesia·Cyrus MotamedChristian Jayr
Aug 25, 2007·Anesthesia and Analgesia·Yaakov BeilinCarol A Bodian
Oct 10, 2002·Regional Anesthesia and Pain Medicine·Scott A LangGary Morris
Dec 3, 2008·International Journal of Obstetric Anesthesia·R AgaramV Gunka
Nov 22, 2005·Journal of Clinical Anesthesia·Rafael Cartagena, Robert R Gaiser
Feb 27, 2017·Journal of Clinical Anesthesia·Yoon-Jung ShonJin Huh

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