title: Desflurane analgesia for vaginal delivery.
abstract: The use of subanaesthetic concentration of inhalational anaesthetic for vaginal delivery offers many advantages to the mother and newborn. Desflurane, with the characteristics of rapid onset and minimal metabolism, may provide better analgesia and safety for labour pain control. Eighty healthy parturients were randomly assigned to receive either desflurane 1.0-4.5% and oxygen (n = 40) or nitrous oxide 30-60% in oxygen (n = 40). Analgesia was assessed using a score from 0 (no relief) to 4+ (excellent analgesia), amnesia for the delivery, blood loss were recorded. Neonates were evaluated by Apgar scores and neurologic and adaptive capacity scores (NACS). Data were analyzed for statistical significance using Student's t-test or Chi-square when appropriate. Analgesia scores were similar for both groups with more amnesia in desflurane group (23% vs 0% P < 0.05). Blood loss did not differ significantly, 364 ml for the desflurane group and 335 ml for the nitrous oxide group. There were no significant differences for neonatal Apgar score at 1 min or at 5 min or the NACS at 2 hr or 24 hr between the two groups. We conclude that desflurane in subanaesthetic doses is safe and effective inhalation agent for normal delivery but might be associated with amnesia.
authors.affiliation: Department of Anesthesiology, Los Angeles County Medical Center, California, USA.
authors.forename: T K
authors.initials: TK
authors.lastname: Abboud
authors.forename: F
authors.initials: F
authors.lastname: Swart
authors.forename: J
authors.initials: J
authors.lastname: Zhu
authors.forename: M M
authors.initials: MM
authors.lastname: Donovan
authors.forename: E
authors.initials: E
authors.lastname: Peres Da Silva
authors.forename: K
authors.initials: K
authors.lastname: Yakal
mesh_terms: D000136:Acid-Base Equilibrium; D000222:Adaptation, Physiological; D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001034:Apgar Score; D001291:Attitude of Health Personnel; D036861:Delivery, Obstetric; D000077335:Desflurane; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007748:Labor Stage, Second; D008568:Memory / Q000187:drug effects; D009460:Neurologic Examination; D009609:Nitrous Oxide / Q000008:administration & dosage; D010146:Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D011247:Pregnancy
chemical_list: D018685:Anesthetics, Inhalation; D000077335:Desflurane; D007530:Isoflurane; D009609:Nitrous Oxide