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DOĞUM ANALJEZİSİNDE EPİDURAL VE KOMBİNESPİNAL-EPİDURAL ANALJEZİ YÖNTEMLERİNİN KARŞILAŞTIRILMASI

A COMPARISON OF EPIDURAL AND COMBINED SPINAL-EPIDURAL ANALGESIA IN LABOUR ANALGESIA

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2008

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Aim: The aim of the study was to compare combined spinal-epidural (CSE) and epidural (EP) analgesia methods in labor analgesia. Material and Methods: The study was performed with 50 primigravid pregnant women who planned to have vaginal delivery. The patients were randomized into two equal groups: Group I: CSE analgesia group and Group II: EP analgesia group. A solution of 0.05% bupivacaine with 1.5 ug/ml fentanyl was prepared for using patient controlled epidural analgesia for both groups. Epidural catheters were introduced following the spinal administration of 1.25 mg bupivacain plus 12.5 ug fentanyl in patients in CSE analgesia group. Epidural solution infusion have been given to the EP analgesia group after the loading dose (10 ml 0.125% bupivacaine and 50 ug fentanil). Data were collected on maternal and fetal hemodynamic varibles, pain scores, motor blockade and total amount of consumed local anesthetic, the side effects. Results: Analgesia was effective in all patients. initiation time of analgesia in CSE group was much shorter than EP group (p<0.05). Better preserved maternal hemodynamics without hypotension, lower amounts of local anesthetics and beter patient satisfaction were observes in the CSE group compared with the EP group (p<0.05). Conclusion: Both CSE and EP analgesia methods used in this study were reliable and satisfactory for labor analgesia. Because of the faster initial analgesia, better maternal hemody-namics, shorter labor time in the first and second stage of labor and lower local anesthetic amounts, CSE analgesia method with lower doses of opioid and local anesthetic can be prefered to EP anal¬gesia method
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Abstract (Original Language): 
Amaç: Bu çalışmada doğum analjezisinde epidural (EP) ve kombine spinal epidural (KSE) analjezi yöntemlerinin karşılaştırılması amaçlandı. Gereç ve Yöntem: Çalışmaya vaginal doğum yapması planlanan 50 primigravid gebe dahil edildi. Olgular Grup I: KSE analjezi, Grup II: EP analjezi grubu olacak şekilde randomize olarak iki gruba ayrıldı. Her iki grup için hasta konrollü epidural analjezide kullanılmak üzere % 0.05 bupivakain + 1.5 ug/ml fentanil solusyonu hazırlandı. KSE analjezi grubundaki gebelere spinal olarak 1.25 mg bupivakain + 12.5 ug fentanil uygulandı ve epidural kateter takıldı. EP analjezi grubunda yükleme dozunu (10 ml % 0.125 bupivakain + 50 ug fentanil) takiben hasta kontrollü epidural analjezi uygulamasına başlandı. Hemodinamik parametreler, ağrı skorları, motor blokaj, lokal anaestezik tüketimi ve yan etkiler kaydedildi. Bulgular: Analjezi tüm olgularda yeterliydi. KSE grubunda analjezinin başlama süresi EP grubuna göre çok kısaydı (p<0.05). KSE grubunda annenin hemodinamisi daha iyi korundu (p<0.05). KSE grubunda lokal anestezik mik¬tarı EP gruba göre daha düşük, hasata memnuniyeti daha iyi bulundu (p<0.05). Sonuç: KSE ve EP analjezi yöntemleri yeterli ve güvenli bir doğum analjezisi sağladı. Ancak analjezik etkinin erken başlaması, maternal hemodinaminin daha stabil seyretmesi, doğumun 1.ve 2. evrelerinin daha kısa sürmesi, tüketilen LA miktarının daha düşük olması nedeni ile doğum analjezisinde düşük doz opioid ve lokal anestezik ile uygulanan KSE analjezi yönteminin, EP analjezi yöntemine tercih edilebileceği kanısındayız.
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  • 4
191-201
  • Turkish

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