Comparison of spinal and epidural anesthesia for caesarean section following epidural labor analgesia
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 11716-11720
Abstract
Background: Epidural labor analgesia (ELA) can be extended for use as epidural surgical anesthesia (ESA) for intrapartum caesarean section. The present study was conducted to compare spinal and epidural anesthesia for caesarean section following epidural labor analgesia.Materials & Methods: 84parturients admitted for vaginal deliveries were divided into 2 groups of 42 each. In group I, epidural painless labor was maintained by continuous infusion and patient-controlled epidural analgesia (PCEA) using 0.125% bupivacaine with fentanyl 1.25 mg/mL.In group II, SA was performed, a standardized dose of hyperbaric bupivacaine 10-12 mg with or without 100-300 mg morphine was administered through a 26- gauge spinal needle.
Results: In group I and group II, parity found to be nullipara in 30 and 34 and multipara in 12 and 8, ASA status was I in 4 and 5, II in 32 and 30 and III in 6 and 7. Cervical oswas 2.9 cm and 3.0 cm, block levelT2-T3 was seen in 0 and 2 and <T4 in 42 and 40 respectively. Failure rate was seen in 4 in group I and 6 in group II. A to S time (min) was 17.4 and 13.2. Medicine given was Ephedrine (mg) as 1.26 and 10.2, Meperidine(mg) as 11.4 and 9.2, Fentanyl (mg) as 0.014 and 0.0052, Midazolam (mg) as 0.81 and 0.23, Propofol (mg) as 8.7 and 4.6 and Ketamine (mg) as 3.16 and 1.92 in group I and II respectively. The difference was significant (P< 0.05).
Conclusion: The failure rate of sequential SA and EA for CS following successful epidural painless labor was similar
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