title: [Opioid spinal anesthesia at the end of labor for potentially difficult deliveries].
abstract: We report two cases of difficult delivery, one vaginal breech presentation and one vaginal twin delivery in agitated parturients who were not given epidura analgesia. Maternal agitation was caused by pain and led to the risk of difficult fetal extraction. Epidural analgesia is not useful during the second stage of labor because of delayed onset of action of the administered drugs. Spinal injection of 10 microg of sufentanil was followed by rapid analgesia, maternal sedation and atraumatic deliveries. The usefulness of this technique is discussed for analgesia during the second stage of labor when epidural analgesia has not been performed.
authors.affiliation: Service d'Anesthésie-Réanimation, Clinique Saint-Paul, Clairière, Fort-de-France.
authors.forename: A
authors.initials: A
authors.lastname: Van Elstraete
authors.forename: T
authors.initials: T
authors.lastname: Lebrun
authors.forename: F
authors.initials: F
authors.lastname: Pastureau
authors.forename: I
authors.initials: I
authors.lastname: Guerrieri
authors.forename: R
authors.initials: R
authors.lastname: Limol
mesh_terms: D000328:Adult; D016362:Analgesia, Obstetrical; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000775:Anesthesia, Spinal; D001946:Breech Presentation; D036861:Delivery, Obstetric; D004420:Dystocia / Q000628:therapy*; D005260:Female; D006801:Humans; D011247:Pregnancy; D017409:Sufentanil / Q000008:administration & dosage / Q000627:therapeutic use*; D014427:Twins
chemical_list: D000701:Analgesics, Opioid; D017409:Sufentanil