Developing and establishing an ideal method of continuous-infusion epidural analgesia for delivery using the double-catheter method.
We evaluated the efficacy of a new method of induction of epidural obstetric analgesia devised by us. The upper and lower catheters used for the epidural double-catheter method were connected to a compression-type disposable injector (Coopdech Syrinjector). 0.125 % bupivacaine + 2 microg/ml fentanyl (6 ml/h) were serially injected via the upper catheter. In the latter half of Stage 1 of labor, the same drugs were continuously infused via the lower catheter (4 ml/h). The mean number of additional drug doses administered via the upper catheter was 0.67+/-0.90 (range: 0-3) when the analgesia induction was commenced after the cervix was dilated to 8 cm in nulliparous women or 6 cm in multiparous women. The method of analgesia was found to be more effective than the conventional method (uncombined continuous infusion of a local anesthetic) for alleviating the pain of the latter half of Stage 1, and Stage 2 of labor. The mean number of additional drug doses injected via the lower catheter was 0.37+/-0.57(range: 0-2). The number of additional doses in the 49 women averaged 0.16 per hour and 1.04 per delivery. Thus, good results were obtained.
Makino
Hidehiro
H
Makino Clinic, Japan.
Iwazaki
Katsuhiko
K
Makino
Tsunehisa
T
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000328:Adult; D016362:Analgesia, Obstetrical; D016058:Analgesia, Patient-Controlled; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage; D001034:Apgar Score; D002045:Bupivacaine / Q000008:administration & dosage; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D036861:Delivery, Obstetric; D004338:Drug Combinations; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous / Q000295:instrumentation / Q000379:methods*; D007747:Labor Stage, First; D007748:Labor Stage, Second; D010298:Parity; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011247:Pregnancy; D012189:Retrospective Studies
D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D004338:Drug Combinations; D005283:Fentanyl; D002045:Bupivacaine