Buradasınız

Anasayfa » Content

Tek Doz Spinal Blok ile Doğum Analjezisi Deneyimlerimiz

Our Experinces in Single-Shot Spinal Block for Labour Analgesia

Journal Name:

  • Selçuk Tıp Dergisi

Publication Year:

  • 2010

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
A single dose spinal analgesia (SDSA) has been defined as an alternative method for the cases which are late for epidural labour analgesia. This study was undertaken to present our experiences on SDSA for multiparous parturients who attended to the obstetrical ward during the advanced stages of labour and requested analgesia. The files of 48 multiparous parturients who applied for SDSA method for labor analgesia between 1 January and 30 July 2009 were retrospectively analyzed. SDSA was performed with 2.5mg levobupivacaine combined with 15µg fentanyl, and 1.2 ml normal saline, using a 27 G pencil point needle in the sitting position. Initiation time of analgesic effect, duration of the second stage of labour lasting after application of SDSA, the number of parturients who needed rescue analgesic and side effects were recorded. SDSA was successfully performed in all parturients. The mean initiation time of analgesic effect and the second stage of labour lasting after application of SDSA were 2.6±0.7/min and 62.2±20 / min, respectively. Six parturients (12.5%) needed rescue analgesic. No side effects were observed except pruritus which occurred in 15 (31%) parturients. The method of SDSA was sufficient in 87.5% of multiparous parturient who requested labour analgesia at the advanced stages of labour. Further studies that include alternative combination of easy and effective methods are needed to increase the success rate of this method.
Bookmark/Search this post with
Abstract (Original Language): 
Tek doz spinal analjezi (TDSA) epidural doğum analjezisi için geç kalınmış vakalarda alternatif bir metod olarak tanımlanmıştır. Bu çalışmanın amacı, obstetri kliniğine doğumun ilerleyen dönemlerinde başvuran ve ağrısız doğum isteği olan multipar gebelerde TDSA deneyimlerimizi sunmaktır. 1 Ocak ve 30 Temmuz 2009 tarihleri arasında, doğum analjezisi için TDSA metodu uygulanan 48 multipar gebenin dosyaları geriye yönelik olarak incelendi. TDSA, 27 G kalem uçlu iğne ile oturur pozisyonda, %5 levobupivakain 2.5mg, 15µg fentanil ve 1.2 ml serum fizyolojik kombinasyonu kullanılarak gerçekleştirildi. Analjezi etki başlama zamanı, TDSA uygulamasından doğumun ikinci döneminin sonlanmasına kadar geçen süre, ek analjezik ihtiyacı olan gebe sayısı ve yan etkiler kaydedildi. TDSA tüm gebelerde başarıyla gerçekleştirildi. Ortalama analjezi başlama zamanı 2.6±0.7 dk ve TDSA uygulamasından doğumun ikinci döneminin sonlanmasına kadar geçen sure 62.2±20 dk idi. Altı gebede (% 12.5) ek analjezik ihtiyacı oldu. Gebelerin 15’inde (% 31) ortaya çıkan kaşıntı dışında yan etki gözlenmedi. Doğumun ileri evresinde analjezi isteği olan multipar gebelerde TDSA metodu hastaların % 87.5’unda yeterli analjezi sağlamaktadır. Bu metodun başarı oranının artırılması için bu metodun kolay uygulanabilir ve hızlı etkili alternatif yöntemlerle kombine edildiği ileri çalışmalara ihtiyaç vardır.
FULL TEXT (PDF): 
PDF icon arastirmax-tek-doz-spinal-blok-ile-dogum-analjezisi-deneyimlerimiz.pdf
  • 2
38-41
  • Turkish

REFERENCES

References: 

1- Eisenach JC. The Pain of childbirth and its effect on the mother and fetus.
In: Chestnut DH, ed. Obstetric anesthesia: principles and practice. ElsevierMosby, Philadelphia, 2004; 288-301.
2- Cosar A. Ağrısız Doğumda Rejyonal Analjezi/Anestezi. Turkiye Klinikleri J
Surg Med Sci 2007; 3: 26-8.
3- Kangas-Saarela T, Kangäs-Karki K. Pain and pain relief in labour:
parturients’ experiences. Int J Obstet Anesth 1994; 3: 67-74.
4- Ranta P, Spalding M, Kangas-Saarela T . Maternal expectations and
experiences of labour pain - options of 1091 Finnish parturients. Acta
Anaesthesiol Scand 1995; 39: 60-6.
5- Collis RE, Baxandall ML, Srikantharajah ID, Edge G, Kadim MY, Morgan
BM. Combined spinal epidural (CSE) analgesia: technique, management,
and outcome of 300 mothers. Int J Obstet Anesth 1994; 3: 75-81.
6- Viscomi CM, Rathmell JP, Pace NL. Duration of intrathecal labor analgesia:
early versus advanced labor. Anesth Analg 1997; 84: 1108-12.
7- Eriksson SL, Blomberg I, Olofsson C. Single-shot intrathecal sufentanil with
bupivacaine in late labour-analgesic quality and obstetric outcome. Eur J
Obstet Gynecol Reprod Biol 2003;110: 131-5.
8- Campbell DC, Camann WR, Datta S. The addition of bupivacaine to
intrathecal sufentanil for labor analgesia. Anesth Analg 1995; 8: 305-9.
9- Viitanen H, Viitanen M, Heikkilä M. Single-shot spinal block for labour
analgesia in multiparous parturients. Acta Anaesthesiol Scand 2005; 49:
1023-9.
10- D’Angelo R, Anderson MT, Philip J, Eisenach JC. Intrathecal sufentanil
compared to epidural bupivacaine for labor analgesia. Anesthesiology
1994; 8: 1209-15.
11- American Society of Anesthesiologists Task Force on Obstetric Anesthesia.
Practice guidelines for obstetric anesthesia: an updated report by the
American Society of Anesthesiologists Task Force on Obstetric Anesthesia.
American Society of Anesthesiologists, Park Ridge, Illinois, USA.
Anesthesiology 2007; 106: 843-63.
12- Ölmez G, Dağ İH, Özyılmaz MA, Yalınkaya A. Doğum Analjesinde Kombine
Spinal-Epidural Yöntem Epidural Yönteme Alternatif mi? Türk Anest Rean
Cem Mec 2003; 31: 66-72.
13- Beilin Y, Bernstein HH, Zucker-Pinchoff B. The optimal distance that a
multiorifice epidural catheter should be threaded into the epidural space.
Anesth Analg 1995; 81: 301-4.
14- Bilgin F. Aðrýsýz Doðumda Kombine Spinal-Epidural Analjezi. Türkiye
Klinikleri J Surg Med Sci 2007; 3: 34-40.
15- Gültekin S. Obstetrik analjezide 1. evrenin ilerlemiş dönemlerinde kombine
spinal-epidural analjezi. Türk Anest ve Rean Cem Mec 2002; 30: 22-6.
16- Abouleish A, Abouleish E, Camann W. Combined spinal–epidural analgesia
in advanced labour. Can J Anaesth 1994; 41: 575–8.
17- Kuczkowski KM, Chandra S. Maternal satisfaction with single-dose spinal
analgesia for labor pain in Indonesia: a landmark study. J Anesth 2008; 22:
55-8.
18- Foster RH, Markham A. Levobupivacaine: a review of its pharmacology and
use as a local anaesthetic. Drugs 2000; 59: 551–79.
19- Nelson KE, Rauch T, Terebuh V, D’Angelo R. A comparison of intrathecal
fentanyl and sufentanil for labor analgesia. Anesthesiology 2002; 96: 1070-
3.
20- Stocks GM, Hallworth SP, Fernando R, England AJ, Columb MO, Lyons G.
Minimum local analgesic dose of intrathecal bupivacaine in labor and the
effect of intrathecal fentanyl. Anesthesiology 2001; 94: 593-8.
21- Birnbach DJ, Hernandez M. Neuraxial Analgesia for Labor. Spinal and
epidural anesthesia. Wong CA, eds. New York: McGraw-Hill; 2007: 271-2.
22- Schug SA, Saunders D, Kurowski I, Paech MJ. Neuraxial drug
administration: a review of treatment options for anaesthesia and analgesia.
CNS Drugs 2006; 20:917–33.
23- Kanazi GE, Aouad MT, Jabbour-Khoury SI, Al Jazzar MD, Alameddine MM,
Al-Yaman R, et al. Effect of low-dose dexmedetomidine or clonidine on the
characteristics of bupivacaine spinal block. Acta Anaesthesiol Scand 2006;
50: 222–7.
24- Balcioglu O, Akin S, Demir S, Aribogan A. Patient-controlled intravenous
analgesia with remifentanil in nulliparous subjects in labor. Expert Opin
Pharmacother 2007; 8: 3089-96.

Thank you for copying data from http://www.arastirmax.com