Effects on mother and fetus of epidural and combined spinal-epidural techniques for labor analgesia.
OBJECTIVE
Epidural (EA) and combined spinal-epidural (CSE) techniques have both been utilized for labor analgesia. This study compared the effects on the mother and newborn of these techniques in labor analgesia and anesthesia.


METHODS
Forty pregnant women received epidural analgesia with 15 mL of 0.125% ropivacaine (EA group) and 5 microg of sufentanil plus 2.5mg bupivacaine in the subarachnoid space (CSE group). Pain intensity, sensory blockade level, latency time, motor block intensity, labor analgesia duration, epidural analgesia duration, maternal hypotension, and pruritus were evaluated. The newborns were evaluated by Apgar and the neurological and adaptive capacity score (NACS) developed by Amiel-Tison.


RESULTS
There were no significant statistical differences between groups for pain scores, latency time, sensory blockade level, and Apgar score. Motor block, labor analgesia duration, and epidural analgesia duration were greater in the CSE group, whose seven mothers had mild pruritus. The NACS were greater in the EA group after half, two, and 24 hours. Ninety five percent of EA group newborns and 60% of CSE group newborns were found to be neurologically healthy at the 24 hour examination.


CONCLUSIONS
EA and CSE analgesia relieved maternal pain during obstetric analgesia, but CSE mothers had pruritus and a longer labor. Newborns of mothers who received epidural analgesia showed the best NACS.
Nakamura
Giane
G
Faculdade de Medicina de Botucatu, UNESP, Botucatu, SP, Brazil.
Ganem
Eliana Marisa
EM
Rugolo
Ligia Maria Suppo de Souza
LM
Castiglia
Yara Marcondes Machado
YM
D000577:Amides; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000379:methods*; D000777:Anesthetics; D016009:Chi-Square Distribution; D005260:Female; D005333:Fetus / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D048949:Labor Pain / Q000503:physiopathology; D007743:Labor, Obstetric / Q000187:drug effects*; D009035:Mothers; D011247:Pregnancy; D011537:Pruritus / Q000139:chemically induced; D000077212:Ropivacaine; D017409:Sufentanil; D055815:Young Adult
D000577:Amides; D000777:Anesthetics; D000077212:Ropivacaine; D017409:Sufentanil