Author/Editor     Uranjek, Jasna; Juvan-Kramer, Katja
Title     Vpliv različnih koncentracij bupivakaina in levobupivakaina s fentanilom na potek poroda v epiduralni analgeziji: retrospektivni pregled
Translated title     Influence of different concentrations of bupivacaine and levobupivacaine with fentanyl on labour in epidural analgesia: retrospective view
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 75, št. 12
Publication year     2006
Volume     str. 787-93
Language     slo
Abstract     Background Labour with epidural analgesia (EDA) is related to prolongation of the second stage of labour and increase in the instrumental vaginal delivery rate. It's not related to higher caesarean section rate. With this review we wanted to compare our results with the literature. Methods Retrospective analysis of labour in EDA in years 2004 and 2005 in Slovenj Gradec General Hospital was done. A comparison with a control group without EDA in the same time period was made. Three different EDA protocols were used during that period. They were compared to control group and between each other. Parturient women data, length of labour, instrumental vaginal delivery rate, caesarean section rate and newborn data were obtained and compared. Analgesic effect, complication rate and influence on labor and delivery were assessed according to EDA protocol used. Results We found statistically significant prolongation of the second stage of labour and increas in the instrumental vaginal delivery rate when EDA was used. Emergency caesarean section rate was not increased. There were no adverse effects on the fetus. All EDA protocol provided clinically efficient analgesia. 0.2% levobupivacaine with 1 micro g of fentanyl/ml of local anesthetic provided statistically significant most effective analgesia. Conclusions EDA means improved quality of labour for a parturient woman. Risk for labour complication with optimal treatment in second stage of labour, which is most affected with EDA, is low.
Summary     Izhodišča Porod v epiduralni analgeziji (EDA) je glede na izsledke večine raziskav povezan s podaljšanjem druge porodne dobe in večjo incidenco izhodnih vaginalnih operacij, ni pa povezan z večjim številom carskih rezov. Z raziskavo smo želeli primerjati naše rezultate s podatki v literaturi. Metode Naredili smo retrospektivno analizo porodov v EDA v letih 2004 in 2005 v Splošni bolnišnici Slovenj Gradec in jih primerjali s kontrolno skupino porodov brez EDA v istem obdobju. V tem času smo uporabljali tri različne protokole za EDA, ki smo jih primerjali med seboj in s kontrolno skupino. Primerjali smo značilnosti porodnic, trajanje poroda, število izhodnih operacij, carskih rezov in ocene stanja novorojenčka po porodu (pH in Apgar po 5 min.). Različne protokole EDA smo primerjali med seboj tudi po učinkovitosti analgezije, po deležu zapletov analgezije in po vplivu na potek poroda. Rezultati EDA je statistično značilno podaljšala drugo porodno dobo ob nekoliko večji incidenci izhodnih vaginalnih operacij in nespremenjenem odstotku nujnih carskih rezov. To ni prineslo slabših rezultatov ocene stanja novorojenčkov. Vse za EDA uporabljene analgetične mešanice so zagotavljale klinično učinkovito analgezijo. Statistično pomembno najugodnejše rezultate je dala mešanica 0,2-odstotnega levobupivakaina z dodatkom 1 mikro g fentanila/ml lokalnega anestetika. Zaključki Uporaba EDA pomeni za porodnico izboljšanje kakovosti poroda. Tveganje za zaplete poroda je ob optimalnem ravnanju v drugi porodni dobi, ki z uporabo EDA nosi največ sprememb, nizko.
Descriptors     LABOR
ANALGESIA, EPIDURAL
BUPIVACAINE
FENTANYL