Faculty of 1000 evaluation for Epidural neostigmine and clonidine improves the quality of combined spinal epidural analgesia in labour: A randomised, double-blind controlled trial.

2013 ◽  
Author(s):  
Bernard Wittels
Keyword(s):  
Epidural Analgesia ◽  
Controlled Trial ◽  
Double Blind ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

scholarly journals SPINAL-EPIDURAL ANALGESIA

2018 ◽  
Vol 25 (10) ◽  
pp. 1568-1573
Author(s):  
Muhammad Saleh Khaskheli ◽  
Rafia Tabassum ◽  
Aijaz Hussan Awan
Keyword(s):  
Epidural Analgesia ◽  
Pain Score ◽  
Controlled Trial ◽  
Surgical Intensive Care Unit ◽  
High Dose ◽  
Surgical Intensive Care ◽  
Double Blind ◽  
Combined Spinal Epidural ◽  
Group I ◽  
Spinal Epidural

Objectives: To compare the efficacy of bupivacaine 2.5 mg and fentanyl 25 ìgwith bupivacaine 1.25 mg and fentanyl 25ìg for spinal-epidural analgesia in the first stage oflabor. Study Design: Double-blind randomized controlled trial. Setting: Anesthesia Department,Surgical Intensive Care Unit, and Pain management clinic, Peoples Medical College HospitalNawabshah. Period: August 2014 to July 2015. Methodology: All the participants meeting theeligibility criteria were randomly allocated into two groups i.e. intervention (I) and control (II),with the allocation ratio of 1:1. Patients in the Group I (intervention) received intrathecal Inj.Bupivacaine 1.25 mg (0.5% Bupivacaine 0.25ml) and Inj. Fentanyl 25 ìg whereas the GroupII (control) was given intrathecal Inj. Bupivacaine 2.5 mg (0.5% Bupivacaine 0.5ml) and Inj.Fentanyl 25 ìg for combined spinal epidural analgesia, both made up of total volume of 2 ml ofnormal saline. Mean±SD (standard deviation) was computed for continuous data (age, weight,VAS). Frequency and percentages was calculated categorical data. Independent t test and Chisquare test were used for the differences between the groups. Results: The age of all the caseswas 27.64±4.07 years. Moreover, groups were homogenous at baseline (p<0.05) in terms ofmean age, weight, cervical dilatation, gravida, and ASA classification. Mean pain score on VASwas not significant between groups at 0 min and 15 min however mean pain score was foundsignificantly low (p<0.05) in group-I. Likewise, efficacy of Bupivacaine 1.25 mg and Fentanyl 25ìg (group-I) was significantly higher than the other group. Conclusion: Low-dose bupivacaine1.25 mg was significantly more effective than high-dose (2.5 mg) bupivacaine when added to25 ìg of fentanyl for combined spinal-epidural analgesia in the first stage of labor, having fewerchances of sensory and motor block, and hypotension.

Epidural Neostigmine and Clonidine Improves the Quality of Combined Spinal-Epidural Analgesia in Labor

2015 ◽  
Vol 35 (2) ◽  
pp. 105-106
Author(s):  
T. Boogmans ◽  
J. Vertommen ◽  
T. Valkenborgh ◽  
S. Devroe ◽  
E. Roofthooft ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

scholarly journals The place of dural puncture epidural as a modern method of pain relief in labor

2021 ◽  
Vol 17 (2) ◽  
pp. 112-115
Author(s):  
A.O. Zhezher ◽  
Ye.M. Sulimenko ◽  
O.A. Loskutov
Keyword(s):  
Side Effects ◽  
Epidural Analgesia ◽  
Dural Puncture ◽  
Epidural Block ◽  
Needle Size ◽  
Combined Spinal Epidural ◽  
Dural Puncture Epidural ◽  
Spinal Epidural ◽  
The Impact

Childbirth is a physiological process that is accompanied by severe pain. Physiological and psychological factors may be involved in the pathological process. Increasing the concentration of catecholamines may help reduce uteroplacental perfusion. Pain during childbirth can lead to hyperventilation of the mother, which in turn can affect the acid-base status of the fetus and the state of the newborn. Prolonged pain can lead to the development of severe psychological disorders with a violation of the connection between mother and newborn. Acute pain during childbirth can transform into chronic in the postpartum period. The most effective are neuroaxial methods of analgesia: epidural analgesia, combined spinal-epidural analgesia and their modifications. Classical epidural analgesia has minimal adverse and side effects, but may be associated with a high incidence of insufficient analgesia. The frequency of inadequate epidural block reaches 23 %. Combined spinal-epidural analgesia, in contrast to epidural analgesia, has a higher quality of sensory block, but it is associated with a higher frequency of side effects such as hypotension, severe motor block, fetal arrhythmia. Since 2005, dural puncture epidural has been introduced into the practice of obstetric anesthesiologists as a method to improve the quality of classical epidural analgesia with minimal side effects of combined spinal-epidural analgesia. Data from existing studies show that dural puncture epidural potentially improves the quality of analgesia (faster onset of analgesia, better sacral coverage, lower incidence of inadequate block) compared with epidural analgesia and causes less hypotension, disorders of fetal heart rate compared with combined spinal-epidural analgesia. But the spinal needle size is important in achieving these effects. Further researches may be aimed at determining the duration of labor, the option of delivery and the possible impact of dural puncture epidural on the vegetative regulation of labor and a broader study of the impact of this method on the fetus and newborn.

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