Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeated cesarean section under epidural anesthesia, a prospective, randomized study

Abstract Background Unsatisfactory analgesia would occur frequently during repeated cesarean section under epidural anesthesia. The aim of this study is to observe the effects of intravenous remifentanil on maternal comfort, maternal and neonatal safety during repeated cesarean section under epidural anesthesia. Methods A total of 80 parturients undergoing repeated cesarean section were involved in the study. The patients were randomly divided into the intravenous remifentanil- assisted epidural group (group R) and epidural group (group E), respectively (n = 40). In group R, the remifentanil was continuously intravenously infused as an adjuvant to epidural anesthesia. In group E, 0.75% ropivacaine epidural or intravenous ketamine was administered as needed. Parturient baseline characteristics, vital signs, VAS scores, and comfort scores during surgery were recorded. Adverse effects were also recorded. Results A total of 80 patients were enrolled in the current study and the final analyses included 39 patients in group R and 38 patients in group E. No differences in patients’ baseline characteristics were found between the two groups (p > 0.05). Compared with group E, the comfort score was significantly higher in group R (9.1 ± 1.0 vs. 7.5 ± 1.3, p < 0.001), whereas the maximum VAS score was significantly lower in group R (1.8 ± 1.2 vs. 4.1 ± 1.0, p < 0.001). Maternal and neonatal adverse effects did not differ between the two groups during surgery (p > 0.05). Conclusions Continuous intravenous infusion of low-dose remifentanil can significantly improve the experience of parturients undergoing repeated cesarean section under epidural anesthesia, without noticeable maternal or neonatal adverse effects. Trial registration This study was pre-registered at http://www.chictr.org.cn/index.aspx (ChiCTR1800018423) on 17/09/2018.

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Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeated cesarean section under epidural anesthesia, a prospective, randomized study

10.21203/rs.2.255/v3 ◽

2019 ◽

Author(s):

wei yan ◽

Yun Xiong ◽

Yu Yao ◽

Feng-jiang Zhang ◽

Li-an Yu ◽

...

Keyword(s):

Adverse Effects ◽

Cesarean Section ◽

Epidural Anesthesia ◽

Intravenous Infusion ◽

Randomized Study ◽

Vital Signs ◽

Continuous Intravenous Infusion ◽

Epidural Group ◽

Vas Scores ◽

Baseline Characteristics

Abstract Background: Unsatisfactory analgesia would occur frequently during repeated cesarean section under epidural anesthesia. The aim of this study is to observe the effects of intravenous remifentanil on maternal comfort, maternal and neonatal safety during repeated cesarean section under epidural anesthesia.Methods: A total of 80 parturients undergoing repeated cesarean section were involved in the study. The patients were randomly divided into the intravenous remifentanil- assisted epidural group (group R) and epidural group (group E), respectively (n=40). In group R, the remifentanil was continuously intravenously infused as an adjuvant to epidural anesthesia. In group E, 0.75% ropivacaine epidural or intravenous ketamine was administered as needed. Parturient baseline characteristics, vital signs, VAS scores, and comfort scores during surgery were recorded. Adverse effects were also recorded.Results: A total of 80 patients were enrolled in the current study and the final analyses included 39 patients in group R and 38 patients in group E. No differences in patients’ baseline characteristics were found between the two groups (p > 0.05). Compared with group E, the comfort score was significantly higher in group R (9.1±1.0 vs. 7.5±1.3, p<0.001), whereas the maximum VAS score was significantly lower in group R (1.8±1.2 vs. 4.1±1.0, p<0.001). Maternal and neonatal adverse effects did not differ between the two groups during surgery (p>0.05).Conclusions: Continuous intravenous infusion of low-dose remifentanil can significantly improve the experience of parturients undergoing repeated cesarean section under epidural anesthesia, without noticeable maternal or neonatal adverse effects.

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Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeated cesarean section under epidural anesthesia, a prospective, randomized study

10.21203/rs.2.255/v2 ◽

2019 ◽

Author(s):

wei yan ◽

Yun Xiong ◽

Yu Yao ◽

Feng-jiang Zhang ◽

Li-an Yu ◽

...

Keyword(s):

Adverse Effects ◽

Cesarean Section ◽

Epidural Anesthesia ◽

Intravenous Infusion ◽

Randomized Study ◽

Vital Signs ◽

Continuous Intravenous Infusion ◽

Epidural Group ◽

Vas Scores ◽

Baseline Characteristics

Abstract Abstract Background: Unsatisfactory analgesia would occur frequently during repeated cesarean section under epidural anesthesia. The aim of this study is to observe the effects of intravenous remifentanil on maternal comfort, maternal and neonatal safety during repeated cesarean section under epidural anesthesia. Methods: A total of 80 parturients undergoing repeated cesarean section were involved in the study. The patients were randomly divided into the intravenous remifentanil- assisted epidural group (group R) and epidural group (group E), respectively (n=40). In group R, the remifentanil was continuously intravenously infused as an adjuvant to epidural anesthesia. In group E, 0.75% ropivacaine epidural or intravenous ketamine was administered as needed. Parturient baseline characteristics, vital signs, VAS scores, and comfort scores during surgery were recorded. Adverse effects were also recorded. Results: A total of 80 patients were enrolled in the current study and the final analyses included 39 patients in group R and 38 patients in group E. No differences in patients’ baseline characteristics were found between the two groups (p > 0.05). Compared with group E, the comfort score was significantly higher in group R (9.1±1.0 vs. 7.5±1.3, p<0.001), whereas the maximum VAS score was significantly lower in group R (1.8±1.2 vs. 4.0±0.9, p<0.001). Maternal and neonatal adverse effects did not differ between the two groups during surgery (p>0.05). Conclusions: Continuous intravenous infusion of low-dose remifentanil can significantly improve the experience of parturients undergoing repeated cesarean section under epidural anesthesia, without noticeable maternal or neonatal adverse effects.

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Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeat cesarean section under epidural anesthesia

10.21203/rs.2.255/v1 ◽

2019 ◽

Author(s):

Wei Yan ◽

Yun Xiong ◽

Yu Yao ◽

Feng-jiang Zhang ◽

Li-an Yu ◽

...

Keyword(s):

Adverse Effects ◽

Cesarean Section ◽

Epidural Anesthesia ◽

Intravenous Infusion ◽

Vital Signs ◽

Continuous Intravenous Infusion ◽

Epidural Group ◽

Vas Scores ◽

Baseline Characteristics ◽

Repeat Cesarean Section

Abstract Background: To observe the effects of intravenous remifentanil on maternal comfort, maternal and neonatal safety during repeat cesarean section under epidural anesthesia. Methods: A total of 80 parturient undergoing repeat cesarean section were involved in the study. The patients were randomly divided into the intravenous remifentanil-assisted epidural group (group R) and epidural group (group E), respectively (n=40). In group R, the remifentanil was continuously intravenously infused as an adjuvant to epidural anesthesia. In group E, 0.75% ropivacaine epidural or intravenous ketamine was administered as needed. Parturient baseline characteristics, vital signs, VAS scores, and comfort scores during surgery were recorded. Adverse effects were also recorded. Results: A total of 80 patients were enrolled in the current study and the final analyses included 39 patients in group R and 38 patients in group E. No differences in patients’ baseline characteristics were found between the two groups (p > 0.05). Compared with group E, the comfort score was significantly higher in group R (9.1±1.0 vs. 7.5±1.3, p<0.001), whereas the maximum VAS score was significantly lower in group R (1.8±1.2 vs. 4.0±0.9, p<0.001). Maternal and neonatal adverse effects did not differ between the two groups during surgery (p>0.05). Conclusions: Continuous intravenous infusion of low-dose remifentanil can significantly improve the experience of parturients undergoing repeat cesarean section under epidural anesthesia, without obvious maternal or neonatal adverse effects. Keywords: Remifentanil; Epidural anesthesia; Repeat cesarean delivery

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Comparing the Analgesic Effect between Continuous Intravenous Infusion of Fentanyl with Clonidine and Fentanyl Only after Cesarean Section

Korean Journal of Anesthesiology ◽

10.4097/kjae.2002.42.4.512 ◽

2002 ◽

Vol 42 (4) ◽

pp. 512

Author(s):

Kyung Im Lim ◽

Sung Ha Moon

Keyword(s):

Cesarean Section ◽

Intravenous Infusion ◽

Analgesic Effect ◽

Continuous Intravenous Infusion

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Nalbuphine versus dexmedetomidine for treatment of combined spinal-epidural post-anesthetic shivering in pregnant women undergoing cesarean section

Journal of International Medical Research ◽

10.1177/0300060519865063 ◽

2019 ◽

Vol 47 (9) ◽

pp. 4442-4453 ◽

Cited By ~ 1

Author(s):

Jing Sun ◽

Zhao Zheng ◽

Yi-Lu Li ◽

Li-Wei Zou ◽

Ge-Hui Li ◽

...

Keyword(s):

Cesarean Section ◽

Pregnant Women ◽

Epidural Anesthesia ◽

Randomized Study ◽

Saline Group ◽

Elective Cesarean Section ◽

Double Blind ◽

Combined Spinal Epidural ◽

Combined Spinal Epidural Anesthesia ◽

Spinal Epidural

Objective This study aimed to compare the clinical efficacy and side effects of nalbuphine and dexmedetomidine for treatment of combined spinal-epidural anesthetic shivering in women after cesarean section. Methods A total of 120 pregnant women, who underwent elective cesarean section under combined spinal-epidural anesthesia, were enrolled in a double-blind, randomized study. These women were randomized into three groups of 40 pregnant women each to receive either saline (group C), nalbuphine 0.07 mg/kg (group N), or dexmedetomidine 0.5 µg/kg (group D) for treatment of shivering after anesthesia. The main outcome measure was a significant reduction in the time required for shivering after intervention. Results The mean time to cessation of shivering in groups N and D was significantly shorter than that in group C (3.5±2.7 and 4.2±3.7 versus 14.5±1.4 minutes). The success rate of shivering treatment and Observer’s Assessment of Alertness/Sedation scores in groups N and D were significantly higher than those in group C, while the recurrence rate was lower than that in group C. Conclusion Nalbuphine 0.07 mg/kg can be used safely and effectively for shivering in pregnant women under combined spinal-epidural anesthesia.

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Optimal Anesthesia Scheme for Transfer to Emergency Cesarean Section in Failed Labor Analgesia Trial Delivery

10.21203/rs.3.rs-512666/v1 ◽

2021 ◽

Author(s):

Wen-hao Bu ◽

Wei Wu ◽

Na Li ◽

Lin Chen ◽

Lin-li Yue

Keyword(s):

Cesarean Section ◽

Epidural Anesthesia ◽

Vital Signs ◽

Labor Analgesia ◽

Emergency Cesarean Section ◽

Combined Spinal Epidural ◽

Emergency Cesarean ◽

The Difference ◽

Combined Spinal Epidural Anesthesia ◽

Spinal Epidural

Abstract Objective： To explore the optimal anesthetic method of transferring to emergency cesarean section after the failure of labor analgesia. Methods: A retrospective study included 1154 patients who underwent cesarean section in Hubei Maternal and Child Health Hospital from January 2019 to January 2020, of which 586 patients were transferred to cesarean section after labor analgesia, They were divided into two groups according to the method of anesthesia: Epidural labor analgesia / Epidural anesthesia (ELA/EA) group : After the failure of natural labor during labor analgesia, local anesthetics continue to be added to the epidural(n=282);Epidural labor analgesia/Combined spinal and epidural anesthesia(ELA/CSEA) group: Combined spinal-epidural anesthesia was performed after spontaneous labor failure during epidural labor analgesia(n=304); Combined spinal and epidural anesthesia(CSEA) group: Patients who undergo emergency cesarean section without labor analgesia(n=568). The case data were reviewed and the anesthetic methods, basic vital signs, medication, time, maternal and infant outcome of the three groups were descriptively analyzed. Results: There was a difference in the time of admission to neonatal delivery, the maximum decrease of diastolic blood pressure and the difference of neonatal 1min apgar score between ELA/EA group and ELA/CSEA group. There was a difference in the dosage of spinal anesthesia between ELA/CSEA group and CSEA group. Conclusion: When the obstetrician anesthesiologist fails during labor analgesia and needs to be transferred to cesarean section, they can choose to re-perform combined spinal-epidural anesthesia, which is beneficial to the early outcome of newborns, but the long-term effect on newborns needs to be further studied.

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