Volume : IX, Issue : III, March - 2019

COMPARISON OF COMBINED SPINAL EPIDURAL ANALGESIA WITH EPIDURAL ANALGESIA USING FENTANYL- BUPIVACAINE COMBINATION FOR EFFECTIVE LABOUR ANALGESIA

Dr. M. Ravikumar, Dr. P. Shanmugasundaram

Abstract :

Labour results in severe pain for most women. When pain relief is available, the vast majority of women request and receive analgesic medication for the treatment of labour pain. The ideal labour analgesic technique should dramatically reduce the pain of labour, while allowing the parturient to actively participate in the birthing experience. In addition, it should have minimal effect on the foetus or the progress of labour. Of all the possible methods of pain relief which can be used in labour, neuraxial blockade (epidural, spinal, CSE, continuous spinal) provides the most effective and least depressant analgesia. Combination of low dose of local anaesthetics and opioid dramatically reduce the incidence of lower limb motor blockade, enabling mothers to walk, sit or stand upright. AIM:  To compare combined spinal epidural analgesia with conventional epidural analgesia using fentanyl–bupivacaine in alleviating labour pain.  To study their effects on the mother and the fetus.  To study their effects on progress of labour and delivery METHODS:Parturients with no antenatal risk factors and expected to have normal vaginal delivery were eligible to be included in the study. Women with known cardiac disease, gestational hypertension, epilepsy or known psychiatric disorder were excluded, as were parturients with multifetal pregnancy, suspected cephalopelvic disproportion and those who have had previous caesarean section. MATERIALS USED: For initiating epidural block, the following were kept ready:– Draping towels and sponge holding forceps, sterile gauze pieces in kidney tray, bowls with antiseptic solution, 18 G Tuohy needle with 20 G portex epidural catheter with filter and loss of resistance syringe for single use, 2ml syringe with 24 G needle for local anaesthetic infiltration, 5 ml and 10ml syringe with needles to draw up fentanyl and bupivacaine respectively, Inj. Bupivacaine – 0.25% preservative free vial, Inj. Lignocaine – 2% vial, Inj. Fentanyl ampoules, distilled water, saline and metal files to open ampoules, delivery tray, baby resuscitation tray and waterproof adhesive plasters. For initiating combined spinal epidural block in addition to above 27 G Quincke needle was kept ready. CONCLUSION: Combined spinal epidural analgesia with fentanyl – bupivacaine combination is thus a safe and better alternative to EA as a technique of neuraxial block for effective labour analgesia.

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

COMPARISON OF COMBINED SPINAL EPIDURAL ANALGESIA WITH EPIDURAL ANALGESIA USING FENTANYL- BUPIVACAINE COMBINATION FOR EFFECTIVE LABOUR ANALGESIA, Dr.M.RaviKumar, Dr.P.Shanmugasundaram INDIAN JOURNAL OF APPLIED RESEARCH : Volume-9 | Issue-3 | March-2019

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