Document Detail


Analgesia with sevoflurane during labour: ii. Sevoflurane compared with Entonox for labour analgesia.
MedLine Citation:
PMID:  17158129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We determined the optimal inspired sevoflurane concentration for use during labour as 0.8% in our previous study. This study compared sevoflurane at a concentration of 0.8% and Entonox((R)) (nitrous oxide 50%: oxygen 50%) for analgesia during labour in 32 healthy parturients. METHODS: Each mother underwent two open-label, three-part sequences in random order, Entonox-sevoflurane-Entonox or sevoflurane-Entonox-sevoflurane. In each part the agent was self-administered during 10 contractions. A 100 mm visual analogue scores for pain relief and sedation was completed immediately after each contraction. RESULTS: Two patients withdrew during administration of sevoflurane (because of its odour) and five during Entonox (requesting epidural analgesia). Of the remaining women, data were available for analysis from 29 participants: median (IQR [range]) pain relief scores were significantly higher for sevoflurane 67 (55-74 [33-100]) mm than for Entonox 51 (40-69.5 [13-100]) mm (P<0.037). Nausea and vomiting were more common in the Entonox group [relative risk 2.7 (95% CI 1.3-5.7); P=0.004]. No other adverse effects were observed in the mothers or babies. There was significantly more sedation with sevoflurane than with Entonox {74 (66.5-81 [32.5-100]) and 51 (41-69.5 [13-100]) mm, respectively; P<0.001}. Twenty-nine patients preferred sevoflurane to Entonox and found its sedative effects helpful. CONCLUSIONS: We conclude that self-administered sevoflurane at subanaesthetic concentration (0.8%) can provide useful pain relief during the first stage of labour, and to a greater extent than Entonox. Although greater sedative effects were experienced with sevoflurane, it was preferred to Entonox.
Authors:
S T Yeo; A Holdcroft; S M Yentis; A Stewart; P Bassett
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  98     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-12     Completed Date:  2007-02-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  110-5     Citation Subset:  IM    
Affiliation:
Magill Department of Anaesthesia, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK. sengyeo@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesia, Obstetrical / adverse effects,  methods*
Analgesia, Patient-Controlled / methods
Anesthetics, Inhalation / administration & dosage*,  adverse effects
Conscious Sedation
Cross-Over Studies
Drug Combinations
Female
Humans
Methyl Ethers / administration & dosage*,  adverse effects
Nausea / chemically induced
Nitrous Oxide / administration & dosage*,  adverse effects
Oxygen / administration & dosage*,  adverse effects
Pain Measurement / methods
Patient Satisfaction
Pregnancy
Vomiting / chemically induced
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Drug Combinations; 0/Methyl Ethers; 10024-97-2/Nitrous Oxide; 28523-86-6/sevoflurane; 54510-89-3/Entonox; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
Br J Anaesth. 2007 Jan;98(1):1-2   [PMID:  17158124 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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