A Comparative Research between Epidural Analgesia versus Dural Puncture Epidural Analgesia in Labor Analgesia
Authors/Creators
- 1. Assistant Professor, Department of Anaesthesiology, Rangaraya Medical College, Kakinada.
- 2. Resident, Rangaraya Medical College, Kakinada
Description
Introduction: Epidural analgesia (EA) is the gold standard technique; inadequate sacral spread and prolonged labor are the limitations. With this background, a study was conducted to compare the EA with dural puncture EA (DPEA) and 0.125% bupivacaine and fentanyl 1mcg/ml were used. Methods: It was a prospective randomized control study conducted in Andhra Medical College, Visakhapatnam. Pregnant women aged >18 years, ASA grade I and II, singleton studycy with vertex presentation with cervical dilatation of 3 – 5 cm and without any labor analgesia contraindication were included in this research. Non cooperative women, ASA grade III & IV were not considered. The study members were divided in to EA and DPEA groups randomly. VAS score was used for pain analysis. Time of onset of adequate was taken as the time between initial injections until the VAS score became 3. Fetomaternal hemodynamics were monitored regularly. The labor progress was recorded by serial per vaginal examinations and mode of delivery and complications such as hypotension, pruritis, motor blockade, nausea, and vomiting were recorded. Modified Bromage scale was used for motor blockade analysis considered. APGAR score at 1 min and 5 min was used for neonatal outcome. Unpaired T test, chi square test were used, P value < 0.05 was considered significant. Results: Total 80 members were included, 40 in each group. Statistically there was no significant difference in the mean duration of labor, respectively. Statistically there was significant difference in mean time for onset of adequate anaesthesia and mean duration, respectively. In both the group majority underwent vaginal delivery, no statistical significance. All the neonates in both groups had > 7 APGAR score, statistically not significant. Conclusion: The DPEA technique stands as a secure alternative to EA. The study could be enhanced through the incorporation of noninvasive imaging techniques to visualize the drug spread.
Abstract (English)
Introduction: Epidural analgesia (EA) is the gold standard technique; inadequate sacral spread and prolonged labor are the limitations. With this background, a study was conducted to compare the EA with dural puncture EA (DPEA) and 0.125% bupivacaine and fentanyl 1mcg/ml were used. Methods: It was a prospective randomized control study conducted in Andhra Medical College, Visakhapatnam. Pregnant women aged >18 years, ASA grade I and II, singleton studycy with vertex presentation with cervical dilatation of 3 – 5 cm and without any labor analgesia contraindication were included in this research. Non cooperative women, ASA grade III & IV were not considered. The study members were divided in to EA and DPEA groups randomly. VAS score was used for pain analysis. Time of onset of adequate was taken as the time between initial injections until the VAS score became 3. Fetomaternal hemodynamics were monitored regularly. The labor progress was recorded by serial per vaginal examinations and mode of delivery and complications such as hypotension, pruritis, motor blockade, nausea, and vomiting were recorded. Modified Bromage scale was used for motor blockade analysis considered. APGAR score at 1 min and 5 min was used for neonatal outcome. Unpaired T test, chi square test were used, P value < 0.05 was considered significant. Results: Total 80 members were included, 40 in each group. Statistically there was no significant difference in the mean duration of labor, respectively. Statistically there was significant difference in mean time for onset of adequate anaesthesia and mean duration, respectively. In both the group majority underwent vaginal delivery, no statistical significance. All the neonates in both groups had > 7 APGAR score, statistically not significant. Conclusion: The DPEA technique stands as a secure alternative to EA. The study could be enhanced through the incorporation of noninvasive imaging techniques to visualize the drug spread.
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IJTPR,Vol14,Issue2,Article39.pdf
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Additional details
Dates
- Accepted
-
2024-02-25
Software
References
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