scholarly journals The Effect of Epidural-Spinal Anesthesia on Labor Outcome and Satisfaction in Parturient Mothers: A Randomized Controlled Trial

2017 ◽  
Vol 2 (4) ◽  
pp. 178-183
Author(s):  
Faegheh Golalizadeh Bibalan ◽  
Fatemeh Shobeiri ◽  
Akram Ranjbar ◽  
Pooran Hagian
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Relief ◽  
Apgar Score ◽  
Controlled Trial ◽  
Labor Pain ◽  
Normal Vaginal Delivery ◽  
Second Stage Of Labor ◽  
Randomized Controlled ◽  
Nulliparous Women ◽  
Significant Difference

Introduction: One of the health system concerns is the use of medications for pain relief during labor and its side effects. Therefore, the aim of this study was to investigate the effect of epiduralspinal anesthesia (combined anesthesia [CA]) on labor outcome and satisfaction in pregnant women. Methods: In this randomized controlled trial study, we included 80 nulliparous women who had been admitted to Fatemieh hospital (Hamadan, Iran) during 2015-2016 due to spontaneous onset of labor. They were randomly assigned into 2 groups of 40, one group with CA versus normal vaginal delivery (NVD) group. Data were collected by using of demographic questionnaire, satisfaction questionnaire, and baby truck scales. Data were analyzed by descriptive and analytical statistics in SPSS version 16.0. Results: Average maternal age (mean ± SD) in the CA group was 26.94 ± 4.34 and in the NVD group was 25.89 ±5.18, respectively. There was a significant difference between the 2 groups in terms of length of second stage of labor (P=0.001), headache (P=0.04), and Apgar score (first minute) (P=0.001). Chi-square test showed a significant difference between the 2 groups in terms of satisfaction with childbirth (P=0.004). Conclusion: In this study, labor pain relief by using the spinal-epidural anesthesia (CA) increased the labor satisfaction. Nevertheless, this approach was associated with some maternal and neonatal complications such as: headaches, length of third stage of labor, and low Apgar score. It seems that the use of this method for painless delivery requires further studies.

scholarly journals Oral Paracetamol versus Oral Paracetamol with Codeine as Intrapartum Analgesic in the First Stage of Labor: Randomized Controlled Trial

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Hashad ◽  
A E Elbohoty ◽  
M E Ahmed ◽  
K M Ibrahim
Keyword(s):  
Randomized Controlled Trial ◽  
Adverse Effects ◽  
Child Labor ◽  
Controlled Trial ◽  
Active Phase ◽  
Labor Pain ◽  
Painful Condition ◽  
Randomized Controlled ◽  
Nulliparous Women ◽  
First Stage Of Labor

Abstract Background Labor pain includes components that differ completely from pain in general. It is the result of natural events and has a special meaning, leading in most cases to something extremely positive, the birth of a healthy child. Labor is a painful condition, considered to be one of the most intense and stressful experiences especially for nulliparous women. Although studies have found significant rise in pain threshold during labor. It is nonetheless an important goal to provide safe and effective methods of analgesia for women in a pain in order, amongst other reasons, to obtain her maximum cooperation. Aim of the Work The aim of this study is to evaluate the efficacy and adverse effects of oral paracetamol (500mg) during the active phase of labor compared with oral solpadeine (paracetamol 500mg with codeine 8mg) as a method for intrapartum analgesia. Patients and Methods This study double blinded randomized controlled trial was conducted on 220 low-risk gravid women have labor pain in first stage of labor and need analgesia comparing the effect of administration of oral paracetamol (500mg) and oral paracetamol 500mg with codeine (8mg) (solpadeine capsule) on managing of pain during active phase of labor. Study setting: The current study was conducted at Ain Shams University Maternity Hospital for about 6 months from February to August 2017. Results As recorded by the VAS score, there was significant pain reduction at 1, 2, 3 and 4 hours in both groups (P = 0.001). The reduction in pain was significantly greater in the solpadeine group only at hour 2 (P = 0.001). Maternal complication as nausea, vomiting, abdominal pain and indigestion were 2 fold to 4 fold more in solpadeine group than in paracetamol group. Conclusion The use of oral paracetamol as analgesia during labor appeared to be effective, safe, done anywhere of labor situations, with no fetal or maternal adverse effects. Using paracetamol as labor analgesia is a new line; it needs to have more chance in comparison with other forms and routs. Also it can be used as adjuvant drug with other types of analgesics. Recommendations Paracetamol may be a good alternative to codeine and opioids as regards analgesic in labor. Maternal and neonatal adverse effects of codeine and opioids as pethidine are good reasons to find another alternative, further randomized controlled trial on wider scale are needed and other forms of paracetamol as suppositories or intravenous are desired to be used as analgesia in different stages of labor and postpartum.

scholarly journals The vertical position during labor: pain and satisfaction

2009 ◽  
Vol 9 (4) ◽  
pp. 393-398 ◽  
Author(s):  
Maria Amelia Miquelutti ◽  
Jose Guilherme Cecatti ◽  
Sirlei Siani Morais ◽  
María Yolanda Makuch
Keyword(s):  
Randomized Controlled Trial ◽  
Patient Satisfaction ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Labor Pain ◽  
Vertical Position ◽  
Efficacy Analysis ◽  
Randomized Controlled ◽  
Nulliparous Women ◽  
The Difference

OBJECTIVES: to evaluate the vertical position adopted by nulliparous women during labor in terms of pain and satisfaction with the position. METHODS: the study was based on a secondary efficacy analysis of data from 107 nulliparous women enrolled in a randomized controlled trial in which the vertical position adopted during the dilation phase of labor was evaluated. The analysis involved comparing the median percentages of the duration for which women remained in the vertical position for each of the variables studied . The Kruskal-Wallis and Mann-Whitney tests were used to determine the difference s betwee n th e groups. Statistical significance was set at p<0.05. RESULTS: at 4cm of dilation , the women with a pain score < 5 remained longer in the vertical position during labor compared to those with a score > 7 (p=0.02) . At 4 and 6 cm of dilation , the women who reported greater satisfaction remained more than 50 % of the time in the vertical position (p=0.0 2 an d p=0.03 , respectively). CONCLUSIONS: the vertical position helped relieve labor pain and increased comfort and patient satisfaction.

A Multicenter, Randomized, Controlled Trial Comparing Bupivacaine with Ropivacaine for Labor Analgesia

2003 ◽  
Vol 98 (6) ◽  
pp. 1431-1435 ◽  
Author(s):  
Stephen H. Halpern ◽  
Terrance W. Breen ◽  
David C. Campbell ◽  
Holly A. Muir ◽  
Jean Kronberg ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Motor Block ◽  
Neonatal Outcome ◽  
Controlled Trial ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Operative Delivery ◽  
Randomized Controlled ◽  
Nulliparous Women ◽  
Multicenter Randomized Controlled Trial

Background A meta-analysis of studies comparing high doses of bupivacaine with ropivacaine for labor pain found a higher incidence of forceps deliveries, motor block, and poorer neonatal outcome with bupivacaine. The purpose of this study was to determine if there is a difference in these outcomes when a low concentration of patient-controlled epidural bupivacaine combined with fentanyl is compared with ropivacaine combined with fentanyl. Methods This was a multicenter, randomized, controlled trial, including term, nulliparous women undergoing induction of labor. For the initiation of analgesia, patients were randomized to receive either 15 ml bupivacaine, 0.1%, or 15 ml ropivacaine, 0.1%, each with 5 microg/ml fentanyl. Analgesia was maintained with patient-controlled analgesia with either local anesthetic, 0.08%, with 2 microg/ml fentanyl. The primary outcome was the incidence of operative delivery. We also examined other obstetric, neonatal, and analgesic outcomes. Results There was no difference in the incidence of operative delivery between the two groups (148 of 276 bupivacaine recipients vs. 135 of 279 ropivacaine recipients; P = 0.25) or any obstetric or neonatal outcome. The incidence of motor block was significantly increased in the bupivacaine group compared with the ropivacaine group at 6 h (47 of 93 vs. 29 of 93, respectively; P = 0.006) and 10 h (29 of 47 vs. 16 of 41, respectively; P = 0.03) after injection. Satisfaction with mobility was higher with ropivacaine than with bupivacaine (mean +/- SD: 76 +/- 23 vs. 72 +/- 23, respectively; P = 0.013). Satisfaction for analgesia at delivery was higher for bupivacaine than for ropivacaine (mean +/- SD: 71 +/- 25 vs. 66 +/- 26, respectively; P = 0.037). Conclusions There was no difference in the incidence of operative delivery or neonatal outcome among nulliparous patients who received low concentrations of bupivacaine or ropivacaine for labor analgesia.

scholarly journals The effect of warm compresses on perineal tear and pain intensity during the second stage of labor: A randomized controlled trial

2021 ◽  
Author(s):  
Soumaya Modoor ◽  
Howieda Fouly ◽  
Hawazen Rawas
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Intensity ◽  
National Guard ◽  
Controlled Trial ◽  
Control Group ◽  
Perineal Tear ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Randomized Controlled ◽  
Significant Difference

Background: Warm compress is believed to reduce perineal tear occurrence and decrease pain intensity during the second stage of childbirth.Objective: This study aimed to determine the effect of warm compresses on perineal tear and pain intensity during the second stage of labor. Methods: A randomized controlled trial was conducted between 28 September 2018 to 30 October 2018 in King Khaled Hospital (KKH), affiliated with the Ministry of National Guard Hospital Affairs, King Abdul-Aziz Medical City Western Region, Saudi Arabia. According to eligibility criteria, the sample randomly recruited through lottery included 100 primigravida pregnant women, with 50 in each intervention and control group. Data were presented in the form of frequency and percentages, standard deviation, and mean. Chi-square test was used for data analysis, with p-value significance at ˂ 0.05.Results: Sociodemographic data revealed no statistically significant difference in the age, education, occupation, and residence of both the control and experimental group. The perineum area’s pain intensity after birth showed a statistically significant difference between the intervention and the control groups (p = 0.001). The perineal tear was also significantly different between both groups (p = 0.001).  Conclusion: The applied warm compresses on the perineum area positively reduce second and third-degree perineal tear and pain intensity during the second stage of labor and after childbirth. Therefore, midwives and nurses are expected to actively provide effective planned in-service training programs regarding warm compresses' advantages in the second stage of labor and apply this procedure actively.

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