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Effect of Combined Spinal Epidural Analgesia on the Progress of Labor and Outcome

Hetal Sonavane , Parth Shah1 , Hetal Sonavane2

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Indian Journal of Anesthesia and Analgesia 6(6):p 2157-2161, November-December 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.44

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Parth Shah, Hetal Sonavane. Effect of Combined Spinal Epidural Analgesia on the Progress of Labor and Outcome. Indian J Anesth Analg. 2019;6(6 Part - II):2157-2161.

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Abstract

Background: The Combined Spinal Epidural (CSE) technique is used with increasing frequency in labor analgesia, because of its rapid onset of excellent analgesia. Aim: Aim of the present research was to study the effect of combined spinal epidural analgesia on the progress of labor and its outcome. Material and Methods: Present study was performed in the Department of Anesthesia and Gynecology at tertiary care institute of Gujarat. History taking and clinical examination was done. A total of 100 parturients receiving combined spinal epidural analgesia was compared with 100 parturient receiving the usual anesthetic used in our labor ward that is tramadol. Progress of labor was recorded in a partogram. The outcome of labor in the form of normal vaginal delivery, instrumental delivery or cesarean section was noted. The indications for cesarean section or instrumental delivery were noted. Neonatal outcome in the form of Apgar scores at 1 minute and 5 minutes and need for intensive care facilities was noted. Results: In cases in nulliparas the mean duration of first stage of labor was significantly reduced in the combined spinal epidural group (339.58 + 70.11 minutes) as compared to controls (400.01 + 109.12 minutes). (p - value 0.011). There was no significant difference in the duration of first stage of labor in multiparous parturients. 92.0% of parturients had a pain score of < 10 in the group receiving combined spinal epidural analgesia and the remaining 8.0% had scores between 11 and 40. In the control group none of the parturients had a pain score of < 70. Conclusion: Labor pain is associated with biochemical and physiological changes that may have adverse effects on both the mothers and the fetus. Combined spinal epidural analgesia is an excellent method of relieving labor pain.

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Cite this article

Parth Shah, Hetal Sonavane. Effect of Combined Spinal Epidural Analgesia on the Progress of Labor and Outcome. Indian J Anesth Analg. 2019;6(6 Part - II):2157-2161.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6619.44

Keywords

Cesarean section; Labor pain; Neonatal; Spinal epidural technique.

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