| Risk factors for failure to extend labor epidural analgesia to epidural anesthesia for Cesarean section. | |
| | |
MedLine Citation:
|
PMID: 16879460 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
AIM: To identify parturients at risk of inability to extend labor epidural analgesia in whom alternative methods of anesthesia should be considered for Cesarean section (CS). METHODS: For 6 months, we prospectively studied women undergoing CS with a functioning epidural catheter in place from the delivery ward. All parturients received the same epidural protocol: bolus of bupivacaine 0.1% and fentanyl, followed by bupivacaine 0.1% and fentanyl (2 microg/ml) 10-15 ml/h and an additional 5 ml of bupivacaine 0.125% as top-up according to patient request. Sixteen milliliters of lidocaine 2%, 1 ml of bicarbonate and 100 microg of fentanyl were given for CS. Failed epidural analgesia was defined as the need to convert to general anesthesia. RESULTS: Of the 101 parturients studied, 20 (19.8%) required conversion to general anesthesia. In univariate analysis, the likelihood of failed epidural anesthesia was inversely correlated with parturient age (P = 0.014) and directly correlated with pre-pregnancy weight (P = 0.019), weight at the end of pregnancy (P = 0.003), body mass index at the end of pregnancy (P = 0.0004), gestational week (P = 0.008), number of top-ups (P = 0.0004) and visual analog scale (VAS) score 2 h before CS (P = 0.03). In multivariate analysis, the number of top-ups in the delivery ward was the best predictor of epidural anesthesia failure (odds ratio, 4.39; P = 0.005). CONCLUSION: Younger, more obese parturients at a higher gestational week, requiring more top-ups during labor and having a higher VAS score in the 2 h before CS are at risk for inability to extend labor epidural analgesia to epidural anesthesia for CS. |
| | |
Authors:
|
S Orbach-Zinger; L Friedman; A Avramovich; N Ilgiaeva; R Orvieto; J Sulkes; L A Eidelman |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Acta anaesthesiologica Scandinavica Volume: 50 ISSN: 0001-5172 ISO Abbreviation: Acta Anaesthesiol Scand Publication Date: 2006 Aug |
Date Detail:
|
Created Date: 2006-08-01 Completed Date: 2006-12-28 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: England |
Other Details:
|
Languages: eng Pagination: 793-7 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology, Rabin Medical Center/Beilinson Campus, Petach-Tiqva 49100, Israel. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Analgesia, Epidural* Analgesia, Obstetrical* Analgesics, Opioid Anesthesia, Epidural* Anesthesia, General Anesthesia, Obstetrical* Anesthetics, Intravenous Anesthetics, Local Bupivacaine Cesarean Section* Emergencies Female Fentanyl Humans Labor Pain / therapy Labor, Obstetric* Pregnancy Risk Factors |
| Chemical | |
Reg. No./Substance:
|
0/Analgesics, Opioid; 0/Anesthetics, Intravenous; 0/Anesthetics, Local; 2180-92-9/Bupivacaine; 437-38-7/Fentanyl |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Association of mu-opioid receptor gene polymorphism (A118G) with variations in morphine consumption ...
Next Document: Low-dose bupivacaine spinal anaesthesia for percutaneous nephrolithotomy: the suitability and impact...