scholarly journals EPIDURAL ANALGESIA;

2008 ◽  
Vol 15 (01) ◽  
pp. 101-103
Author(s):  
MUHAMMAD ASGHAR KHAN ◽  
BILAL YASIN ◽  
MONA ZAFFAR ◽  
Shafi ur Rehman

Introduction. The influence of epidural analgesia on the length of labourremains a source of controversy in literature. Objectives. To see the effect of epidural analgesia on the duration ofactive first stage and second stage of labour. Setting: Obstetric Department of CMH Kharian. Period: From 1 January st2005 to 31 March 2006. Material and methods. One hundred pregnant full term, women were included in the study. stFifty primiparous reporting at full term, half were given epidural analgesia the other half were control. Another fiftymultiparous reporting at full term, twenty five women were given epidural the other twenty five were control. Results.The mean duration of active first stage of labour in primiparous women after 3 – 4 centimeter cervical dilatation was5.10 hrs in the epidural group while it was 6.65 hrs in the control group (p less than 0.001). In the multiparous womenthe mean duration of active first stage of labour after 3 – 4 centimeter cervical dilatation was 2.40 hrs in the epiduralgroup while it was 3.43 hrs in the control group (p less than 0.001). In the primiparous women the mean second stagewas 23.76 minutes in the epidural group, and 37.33 minutes in the control group (p less than 0.001). In the multiparousgroup, the mean second stage was 17.58 minutes in the epidural group, and 22.00 minutes in the control group (p lessthan 0.001). Conclusion. Epidural analgesia decreases the duration of active first stage and second stage of labour.

1990 ◽  
Vol 45 (7) ◽  
pp. 457
Author(s):  
NIGEL J. ST. G. SAUNDERS ◽  
HELEN SPIBY ◽  
LUCY GILBERT ◽  
ROBERT B. FRASER ◽  
JACQUELINE M. HALL ◽  
...  

Author(s):  
Lubna Javed ◽  
Anbrin Salick ◽  
Naheed Jamal Faruqi

Aims & Objectives: To study the effect of epidural analgesia (EA) in labour on the rate of instrumental deliveries Study Design: Clinical Trial / Case Control study. Study Settings: Labour ward of Jinnah Hospital, Lahore during one year period from July 2002 to June 2003. Patients and Methods: One hundred women in labor at term were divided into two equal groups. Group-I comprised of those women who were provided with epidural analgesia while group-II consisted of those women who had labour without the block. The anesthetist provided epidural analgesia using 0.125% bupivacaine and the obstetrician or midwife gave intermittent top-ups. Main Outcome Measures: The main outcome measures were the effect of epidural analgesia on the duration of second stage of labor and the rate of instrumental deliveries. The data was collected on a pre-designed proforma and was analyzed on computer software (SPSS). Ratio and proportions were calculated and Chi-square test was used to check significant association between the groups. P<.05 was considered statistically significant. Results: Gestational age, gravidity, duration of first stage of labour, and fetal outcome were comparable between the two groups. There was prolongation of second stage of labour (P < 0.05). 30% of the parturient in the group with epidural analgesia had second stage of <1 hour while there were 84 % of women in the control group who had second stage of <1 hour. 66% of the women in group I (EA) had duration of second stage of 1-2hours while in group-II 16% of women delivered in the same period. 4% of the women in the study group had second stage of >2hours while there was none (0.0%) who took >2hours in the control group. There was an increased rate of instrumental deliveries in patients with epidural analgesia (P<0.05). 40% of women had instrumental deliveries in the study group as compared to 10 % in the control group. Patient satisfaction was excellent among parturient given EA, 94 % of the parturient being very satisfied. Conclusion: Epidural analgesia along with an experienced anesthetist, a dedicated obstetrician and a trained midwife can convert the painful labour into a less stressful event. Although it prolongs the second stage of labour and increases the rate of instrumental deliveries yet its advantages of pain free labour, better psychological outcome and no significant complications outweigh these drawbacks.


2021 ◽  
pp. 10-13
Author(s):  
R.Shanthi Malar ◽  
V. Vijayalakshmi ◽  
P. Thenmozhi

BACKGROUND:Pain relief during labour is an important component of modern obstetric care and can be produced by neuraxial, systemic or inhalational analgesia. Recent meta-analyses have supported epidural analgesia as the most efficacious technique.A good labour analgesia should aim at good pain relief during delivery process,at the same time not causing foetal acidosis,ensures safe for both mother and the baby. AIM OF THE STUDY:To study the influence of epidural analgesia on maternal and neonatal outcome MATERIALS AND METHODS:The study was conducted in the depar tment of Obstet r ics and Gynecology,GOVT.Stanley Medical College,Govt.RSRM LYING IN HOSPITAL,CHENNAI over a period of eight months from July 2019 to February 2021. The study was performed in 120 selected subjects. The study subjects were divided based on intervention – labour analgesia into 2 study groups. In this study,change in vital parameters,fetal heart rate,assessment of pain score,Duration of first and second stage of labour,mode of delivery,APGAR score and the need for NICU admission were noted and recorded.Any complications during the course of labour were also recorded. RESULTS:In this study,there was no significant difference in the mean duration of first and second stage of labour in both the study and control groups.The mean Apgar score of babies at one minute was 7.02 and at 5 minutes was 8.07 in the labour analgesia group and showed no significance.Maternal satisfaction for the effect of epidural analgesia,60.00% of the patients of epidural analgesia, the incidence of satisfactory/very satisfactory experience was meaningfully and significantly more in labour analgesia group subjects compared to control group subjects by 30 % with a 2 fold increase. CONCLUSION: As per this study labour analgesia using neuroaxial blockade technique are more likely to encounter increasing maternal satisfaction and good quality labour pain reduction.


Author(s):  
Ruby Kumari

Aim: To highlights the maternal and neonatal outcome of caesarean section in second stage of labour. Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynecology at Government Medical College and Hospital Bettiah, Bihar, India from December 2017 to December  2018. total of 24600 women delivered by caesarean section, 16800 emergency and 7800 elective cases. Of these 400 were at full cervical dilatation, >37 weeks gestation with a singleton fetus in cephalic presentation. All caesarean sections performed at full cervical dilatation over the time period of 1 year at a government hospital were included. Results: Among the 400 patient’s majority of them were in the age group of 20-30 years (72.5%). about 75.5% of the patients were primigravidae and only the remaining 24.5% were multigravida. The commonest indications for doing caesarean section in the second stage of labour were cephalo pelvic disproportion, fetal distress and obstructed labour. Incidence of PPH is 48 out of 400 cases (12%). Post-operative wound infection was seen in 23(5.75%) and Post-operative fever was seen in 70(17.5%) out of 400 cases. There were no cases of maternal deaths reported. The mean operative time was 52.9 min .The mean length of hospital stays was 6.6 days. Mean weight of the babies of the second stage caesarean section was 3.2 kg. Conclusions: Caesarean sections done in second stage of labour are associated with several intra-operative maternal complications and neonatal morbidity. Keywords: Caesarean complications; emergency caesarean section; maternal morbidity; neonatal morbidity


2021 ◽  
Vol 10 (12) ◽  
pp. 2637
Author(s):  
Mª. Ángeles del Buey-Sayas ◽  
Elena Lanchares-Sancho ◽  
Pilar Campins-Falcó ◽  
María Dolores Pinazo-Durán ◽  
Cristina Peris-Martínez

Purpose: To evaluate and compare corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness (CCT), measurements were taken between a healthy population (controls), patients diagnosed with glaucoma (DG), and glaucoma suspect patients due to ocular hypertension (OHT), family history of glaucoma (FHG), or glaucoma-like optic discs (GLD). Additionally, Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated IOP (IOPcc) were compared between the different groups of patients. Methods: In this prospective analytical-observational study, a total of 1065 patients (one eye of each) were recruited to undergo Ocular Response Analyzer (ORA) testing, ultrasound pachymetry, and clinical examination. Corneal biomechanical parameters (CH, CRF), CCT, IOPg, and IOPcc were measured in the control group (n = 574) and the other groups: DG (n = 147), FHG (n = 78), GLD (n = 90), and OHT (n = 176). We performed a variance analysis (ANOVA) for all the dependent variables according to the different diagnostic categories with multiple comparisons to identify the differences between the diagnostic categories, deeming p < 0.05 as statistically significant. Results: The mean CH in the DG group (9.69 mmHg) was significantly lower compared to controls (10.75 mmHg; mean difference 1.05, p < 0.001), FHG (10.70 mmHg; mean difference 1.00, p < 0.05), GLD (10.63 mmHg; mean difference 0.93, p < 0.05) and OHT (10.54 mmHg; mean difference 0.84, p < 0.05). No glaucoma suspects (FHG, GLD, OHT groups) presented significant differences between themselves and the control group (p = 1.00). No statistically significant differences were found in the mean CRF between DG (11.18 mmHg) and the control group (10.75 mmHg; mean difference 0.42, p = 0.40). The FHG and OHT groups showed significantly higher mean CRF values (12.32 and 12.41 mmHg, respectively) than the DG group (11.18 mmHg), with mean differences of 1.13 (p < 0.05) and 1.22 (p < 0.001), respectively. No statistically significant differences were found in CCT in the analysis between DG (562 μ) and the other groups (control = 556 μ, FHG = 576 μ, GLD = 569 μ, OHT = 570 μ). The means of IOPg and IOPcc values were higher in the DG patient and suspect groups than in the control group, with statistically significant differences in all groups (p < 0.001). Conclusion: This study presents corneal biomechanical values (CH, CRF), CCT, IOPg, and IOPcc for diagnosed glaucoma patients, three suspected glaucoma groups, and a healthy population, using the ORA. Mean CH values were markedly lower in the DG group (diagnosed with glaucoma damage) compared to the other groups. No significant difference was found in CCT between the DG and control groups. Unexpectedly, CRF showed higher values in all groups than in the control group, but the difference was only statistically significant in the suspect groups (FHG, GLD, and OHT), not in the DG group.


1995 ◽  
Vol 23 (4) ◽  
pp. 459-463 ◽  
Author(s):  
M. J. Paech ◽  
T. J. G. Pavy ◽  
C. Sims ◽  
M. D. Westmore ◽  
J. M. Storey ◽  
...  

A prospective randomized study was Performed to detail clinical experience with both patient-controlled epidural analgesia (PCEA) and midwife-administered intermittent bolus (IB) epidural analgesia during labour, under the conditions pertaining in a busy obstetric delivery unit. Both methods used 0.125% bupivacaine plus fentanyl, and similar rescue supplementation although management decisions related to epidural analgesia were made principally by attending midwives One hundred and ninety-eight women were recruited and data analysed from 167 (PCEA n = 82 IB n=85) The groups were demographically similar. Median hourly pain scores, ratings of analgesia and satisfaction did not differ Maximum pain scores were significantly higher in those receiving IB epidural analgesia (P<0.05). The PCEA group had a significantly higher rate of supplementation and bupivacaine use (P<0.01), and a longer duration of the second stage of labour (P<0.03) The relative risk of instrumental delivery with PCEA versus the IB method was 1.57 (CI 1.07–2.38) Experience within our unit with PCEA is contrasted with that of IB epidural analgesia, the method most commonly used; and with that of controlled trials comparing these two methods.


2020 ◽  
Vol 7 (8) ◽  
pp. 598-602
Author(s):  
Ümit Yasemin Sert ◽  
Özlem Uzunlar ◽  
Nezaket Kadıoğlu ◽  
Tuba Candar ◽  
Yaprak Engin Üstün

Objective: Water immersion and epidural analgesia are both pain relief methods used to perceive less pain during the labor process. There are concerns about the maternal and fetal outcomes, although studies presented no significant complication directly related to these methods. We aimed to compare the IL-1 and 6 levels, Total serum oxidant (TOS), antioxidant (TAS) and catalase levels of births with epidural analgesia, water immersion and conventional birth without analgesia. Material and Methods: A total of 88 patients were included in the study (The water immersion group included 29 patients, while the epidural analgesia and control group included 30 and 29 patients respectively). Umblical cord IL-1, IL-6, catalase, TAS, TOS levels, neonatal Apgar scores, duration of birth process and demographic data were compared between three groups Results: There was no significant difference between the three groups in terms of age, Body mass index (BMI), gravidity, parity, gestational week, and birth weight (p>0.05). TOS and IL-6 levels were significantly lower in epidural group than others (p=0.031, p=0.019 respectively). Apgar scores were significantly lower in epidural group (p<0.001). Conclusion: The water immersion and epidural analgesia were found to have no adverse effect on oxidative status and infection parameters of women.


2019 ◽  
Author(s):  
Caroline Yavari ◽  
Seyedeh Zahra Masoumi ◽  
Farideh Kazemi ◽  
Mansoureh Refaei ◽  
Abolghasem Yaghoobi

Abstract Background: Childbirth is an important experience in the woman's life; and its quality has short- and long-term effects on them. The present study aimed to determine the effect of positive mental imagery on the labor pain tolerance in primiparous women referred to Atieh teaching-medical center in Hamadan.Method: The present clinical trial study was conducted on 90 primiparous mothers referred to Atieh Hospital of Hamadan in interventional (n= 45) and control (n= 45) groups. Data collection tools included demographic information forms, Behavioral pain scale, Visual analogue scale (VAS), and the birth registration checklist that were responded by both groups through interviews and observation during labor. The intervention group participated in 4 weekly counseling sessions in groups of 5 to 7 participants, but the control group received only routine care. Finally, the obtained data from above questionnaires was analyzed using SPSS 21 and analysis of covariance (ANCOVA), Independent t-test and chi-square test and the significance level of tests was considered to be at the level of 5%.Results: The research results indicated that the mean age of control and intervention groups was 25.98±4.82 and 25.32± 4.85 respectively. The mean scores of Visual analogue scale (VAS) and the Behavioral Pain Scale significantly decreased compared to the control group (P <0.001). The mean scores of behavioral changes in the intervention group were 1.77 ± 0.68, 2.39± 0.54 and 3.09±0.60 in 4-5 cm, 6-7 cm and 8-10 cm dilatations respectively. That was statistically significant decrease compared to the control group (P=0.005). Conclusion: Positive mental imagery counseling reduced the visual analogue intensity and behavioral pain intensity in primiparous women. It seems that continuing education and counseling during pregnancy and empowering mothers to control themselves and learn mental imagery techniques and practice during pregnancy and childbirth can help mothers to more relax and alleviate the labor pain intensity.Trial registration: Trial Registration Clinical Trial Registry: IRCT20120215009014N242.Registered on 2017-09-10. https://en.irct.ir/trial/9621Sampling start date:2018-10-23


Sign in / Sign up

Export Citation Format

Share Document