Indranil Sikdar1, Shivinder Singh2, Rangraj Setlur3, C V R Mohan4, Rashmi Datta3, S R Patrikar5. 1. Graded Specialist (Anaesthesia), MH Kirkee, Pune, India. 2. Associate Professor, Department of Anaesthesiology & Critical Care, Armed Forces Medical College, Pune 40, India. 3. Senior Advisor (Anaesthesiology & Critical Care), Army Hospital (R&R), Delhi Cantt 10, India. 4. Professor & Head (Anaesthesiology), MS Ramaiah Medical College, Bengaluru, India. 5. Lecturer in Biostatistics & Demography, Dept of Community Medicine, Armed Forces Medical College, Pune 40, India.
Abstract
BACKGROUND: The structured labor analgesia programme in our tertiary care hospital has been in place for the past few years. We undertook this study to analyze the programme and to draw conclusions to further improve the outcomes. METHODS: A prospective analysis of the data pertaining to 200 patients participating in an ongoing labor analgesia programme in a tertiary care hospital from Nov 2008 to Aug 2009 was performed. RESULTS: Mean visual analog score (VAS) before epidural block was 8.34 ± 0.79. Post procedure the average VAS score was 2.20 ± 0.79. One hundred and fifty six (78%) parturients delivered vaginally, 18 (9%) required instrumentation with vacuum including 1 forceps delivery in a multiparous parturient. In 17parturients (8.7%) fetal distress led to a decision to perform LSCS for delivery. Multiparous patients were significantly more satisfied as compared to nulliparous patients (p = 0.010). CONCLUSION: The study demonstrated excellent pain relief and patient satisfaction with minimal complications. The safety and efficacy of epidural bupivacaine in concentrations less than 0.625% combined with 25 mcg of fentanyl demonstrated in our study should be considered are commendation for the widespread adoption of the procedure in tertiary care hospitals.
BACKGROUND: The structured labor analgesia programme in our tertiary care hospital has been in place for the past few years. We undertook this study to analyze the programme and to draw conclusions to further improve the outcomes. METHODS: A prospective analysis of the data pertaining to 200 patients participating in an ongoing labor analgesia programme in a tertiary care hospital from Nov 2008 to Aug 2009 was performed. RESULTS: Mean visual analog score (VAS) before epidural block was 8.34 ± 0.79. Post procedure the average VAS score was 2.20 ± 0.79. One hundred and fifty six (78%) parturients delivered vaginally, 18 (9%) required instrumentation with vacuum including 1 forceps delivery in a multiparous parturient. In 17parturients (8.7%) fetal distress led to a decision to perform LSCS for delivery. Multiparous patients were significantly more satisfied as compared to nulliparous patients (p = 0.010). CONCLUSION: The study demonstrated excellent pain relief and patient satisfaction with minimal complications. The safety and efficacy of epidural bupivacaine in concentrations less than 0.625% combined with 25 mcg of fentanyl demonstrated in our study should be considered are commendation for the widespread adoption of the procedure in tertiary care hospitals.
Authors: Leanne Jones; Mohammad Othman; Therese Dowswell; Zarko Alfirevic; Simon Gates; Mary Newburn; Susan Jordan; Tina Lavender; James P Neilson Journal: Cochrane Database Syst Rev Date: 2012-03-14