Effects of intrapartum epidural analgesia at high altitudes: maternal, fetal, and neonatal outcomes. A randomized controlled trial of two formulations of analgesics.
Acta Obstet Gynecol Scand
; 89(7): 909-15, 2010 Jul.
Article
en En
| MEDLINE
| ID: mdl-20583937
ABSTRACT
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 OUTCOMEMEASURES:
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.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Bupivacaína
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Resultado del Embarazo
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Analgesia Epidural
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Fentanilo
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Analgesia Obstétrica
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Altitud
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Amidas
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Newborn
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Pregnancy
País como asunto:
Asia
Idioma:
En
Año:
2010
Tipo del documento:
Article