Avtor/Urednik		Sredanović, Drago; Merkun, Maja
Naslov		Vpliv epiduralne porodne analgezije v nizkem odmerku na potek in izid poroda
Prevedeni naslov		Effect of low-dose epidural parturition analgesy on continuation and outcome of labour
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 76, št. 11
Leto izdaje		2007
Obseg		str. 753-7
Jezik		slo
Abstrakt		Background Epidural parturition analgesia (EPA) is commonly employed technique of providing pain relief during labour. The newer form of low-dose intermittent EPA has been in the recent studies presented as solid, according to parturitient’s wish. The main goal of our review was to strenghten the influence of this form of EPA on continuation, mode and outcome of labour. Methods We have retrospectively analysed all the labours in years 2005 and 2006 in nulliparous women in labour at term with the head presentation of fetus. They were divided in two groups ‐ with and without EPA. Analgetic mixture of EPA contained 0.1% bupivacain and 2 µg of phentanyl/mL of local anesthetic. Main features of parturitients, duration of labour and outcomes of labour on mother and newborn were compared. We have excluded all labours with fetal breech presentation, multiple pregnancies, elective caesarean sections and all labours finished before 37th week of pregnancy. Results In nulliparous women with low-dose intermittent EPA labour was a bit longer and often finished with vacuum extraction. However level of caesarean sections was unchanged. In comparision with group without EPA the outcomes in newborns were not essentially different. Conclusions Use of low-dose intermittent EPA is acceptable and safe method of decreasing the labour pains, ensuring good outcomes in mother and newborn despite higher risk.
Izvleček		Izhodišča Epiduralna porodna analgezija (EPA) je najučinkovitejši način lajšanja porodne bolečine. Novejša oblika nizkodozne intermitentne EPA se je v dosedanjih raziskavah izkazala za zanesljivo, varno in s strani porodnic zaželeno metodo. Namen naše raziskave je bil potrditi ugotovljen vpliv te oblike EPA na potek, način in izid poroda. Metode Retrospektivno smo analizirali vse porode v Splošni bolnišnici Jesenice (SBJ) v letih 2005 in 2006 pri prvesnicah ob roku poroda s plodom v glavični vstavi. Razdelili smo jih na dve skupini ‐ z EPA in brez nje. Analgetična mešanica za EPA je vsebovala 0,1% bupivakain in 2 µg fentanila/mL lokalnega anestetika. Primerjali smo splošne lastnosti porodnic, trajanje poroda in izid poroda za mater in novorojenca. Iz raziskave smo izključili vse prvesnice z elektivnim carskim rezom (CR), s plodom v medenični vstavi, z večplodno nosečnostjo in s porodom pred dopolnjenim 37. tednom nosečnosti. Rezultati Pri prvesnicah z intermitentno EPA v nizkem odmerku je bil porod nekoliko podaljšan, pogosteje dokončan z vakuumsko ekstrakcijo (VE), delež CR pa je ostal enak. V primerjavi s skupino brez EPA se izidi pri novorojencih niso bistveno razlikovali. Zaključki Uporaba intermitentne EPA v nizkem odmerku je sprejemljiva in varna metoda lajšanja porodnih bolečin, ki zagotavlja dobre izide materi in novorojencu kljub izpostavljenosti večjemu tveganju.
Deskriptorji		ANALGESIA, OBSTETRICAL ANALGESIA, EPIDURAL VACUUM EXTRACTION, OBSTETRICAL CESAREAN SECTION