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Relief of Labor Pain by Adding Intrathecal Low Dose Epinephrine to Bupivacaine and Fentanyl
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M Jabalameli   1, S Zahiri |
| 1- , Jabalameli@med.mui.ac.ir |
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Abstract: (4500 Views) |
| ABSTRACT:
Intrduction & Objective: There are several methods for relief of labor pain but not all are appropriate for every patient. In intrathecal block, administration of local anesthetic and patient management in labor process should be with supervision of an experienced physician. Agents used for this purpose consisted of: chlorprocaine, bupivacaine and lidocaine. Drug concentration and volume depend on level and degree of sensory and motor block. Recently, intrathecal epinephrine 25 microgram and even 200 microgram, has been used for prolonging labor analgesia along with opioids and local anesthetics. The aim of this study was to assess the effect of intrathecal low dose epinephrine on pain intensity and duration of labour.
Materials & Methods: This clinical trial study was performed on 60 parturients. After starting the active phase of labor (cervix dilatation of 5 cm), spinal analgesia was done in all of the patients. In conventional group analgesia was achieved by 1.5 ml bupivacaine of 0.125 percent, 15 microgram fentanyl, along with 1.25 microgram epinephrine(1:800000) and the same drugs except for epinephrine were used in the control group. Pain intensity before and after block, analgesia duration, systolic and diastolic blood pressure, heart rate, frequency of nausea and vomiting in mother, and first and 5th APGAR scores in neonates were recorded.
Results: Complete analgesia duration was 95.3 + 18.2 and 81.2 + 15.1 minutes in epinephrine group and in control group (without epinephrine), respectively. Mean pain intensity score in epinephrine group was less than that of the control group but the difference was not statistically significant. There was no significant difference in the frequency of nausea and vomitting, heart rates, systolic and diastolic pressure in mother and APGAR scores between two groups .
Conclusion: Intrathecal low dose epinephrine with bupivacaine and fentanyl can prolong duration of analgesia and relieve pain intensity without any side-effects on mother and fetus . |
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| Keywords: KEYWORDS : Painless labor, Intrathecal, Bupivacaine, Epinephrine, Fentanyl |
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Full-Text [PDF 202 kb]
(1089 Downloads)
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Type of Study: Research |
Subject:
Special
Received: 2015/06/6 | Accepted: 2015/06/6 | Published: 2015/06/6
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