Document Detail


Effects of intrapartum epidural analgesia at high altitudes: maternal, fetal, and neonatal outcomes. A randomized controlled trial of two formulations of analgesics.
MedLine Citation:
PMID:  20583937     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To investigate whether intrapartum epidural analgesics (bupivacaine or ropivacaine) have an influence (safety and efficacy) on mothers, fetuses, or newborns at high altitudes (2,200 m above the sea level). DESIGN: Prospective randomized trial. SETTING: A tertiary referral hospital in Aseer region, Saudi Arabia. POPULATION: Eighty parturient women with normal full term pregnancy (37-40 weeks) were randomly allocated to a group receiving epidural bupivacaine 0.125% and the other receiving ropivacaine 0.2%, with fentanyl 100 microg given to both groups. METHODS: Intra- and postpartum clinical management of the pregnant women and newborns and fetal Doppler assessments were performed. MAIN OUTCOME MEASURES: Severity of pain, onset and duration of analgesia, and occurrence of motor blockade were primary outcomes. Progress of labor, need for oxytocin augmentation, mode of delivery, and neonatal condition were secondary outcomes. RESULTS: Demographic, labor characteristics, and neonatal outcomes of the two groups were comparable. The onset of analgesia was relatively more rapid for ropivacaine group (p = 0.067). Duration of analgesia after the first bolus dose was longer and the need for supplemental epidural analgesic doses was lesser in the bupivacaine group (p = 0.041 and 0.045, respectively). In both groups, the fetal umbilical and middle cerebral artery pulsatility indices showed significant change when compared to the baseline of the same group. CONCLUSION: At high altitudes, no major advantage was found for epidural ropivacaine over bupivacaine in addition to fentanyl for labor analgesia and no harmful effects of the medications were found on mothers, fetuses, or newborns.
Authors:
Mahmoud Shokry; Essam M Manaa; Randa Ali Shoukry; Mohamed Hossam Shokeir; Ghada O Elsedfy; Abd El-Salam Abd El-Aziz
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  89     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-29     Completed Date:  2010-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  909-15     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt. mshromih@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Altitude*
Amides / administration & dosage*
Analgesia, Epidural / adverse effects,  methods*
Analgesia, Obstetrical / adverse effects,  methods*
Apgar Score
Atmospheric Pressure
Bupivacaine / administration & dosage*
Chi-Square Distribution
Female
Fentanyl / administration & dosage*
Follow-Up Studies
Heart Rate, Fetal / drug effects
Humans
Infant, Newborn
Infant, Newborn, Diseases / diagnosis,  epidemiology
Pain Measurement
Postpartum Period
Pregnancy
Pregnancy Outcome*
Probability
Prospective Studies
Risk Assessment
Saudi Arabia
Term Birth
Ultrasonography, Prenatal
Young Adult
Chemical
Reg. No./Substance:
0/Amides; 2180-92-9/Bupivacaine; 437-38-7/Fentanyl; 84057-95-4/ropivacaine

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


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