Low dose bupivacaine/fentanyl epidural infusions in labour and mode of delivery
Summary The aim of this study was to determine the effect on the instrumental delivery rate of two different concentrations of bupivacaine combined with fentanyl in epidural infusions during labour. Only primiparous women in whom a spontaneous vaginal delivery was anticipated, were included in the s...
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| Veröffentlicht in: | Anaesthesia 1994-12, Vol.49 (12), p.1087-1090 |
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| creator | Stoddart, A. P. Nicholson, K. E. A. Popham, P. A. |
| description | Summary
The aim of this study was to determine the effect on the instrumental delivery rate of two different concentrations of bupivacaine combined with fentanyl in epidural infusions during labour. Only primiparous women in whom a spontaneous vaginal delivery was anticipated, were included in the study. Those women receiving a higher concentration of bupivacaine and therefore a greater amount of local anaesthetic agent during labour were significantly more likely to have an instrumental delivery with Kielland's rotational forceps (p < 0.01). Those women receiving a lower concentration and smaller amount of bupivacaine were significantly more likely to have an instrumental delivery with Neville‐Barnes forceps (p < 0.05). This provides evidence to support the theory that epidural analgesia may contribute to inadequate rotation of the presenting fetal part due to weakened pelvic floor muscles and that this is more likely to occur when higher concentrations of bupivacaine are used and a greater degree of motor block occurs. |
| doi_str_mv | 10.1111/j.1365-2044.1994.tb04362.x |
| format | Article |
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The aim of this study was to determine the effect on the instrumental delivery rate of two different concentrations of bupivacaine combined with fentanyl in epidural infusions during labour. Only primiparous women in whom a spontaneous vaginal delivery was anticipated, were included in the study. Those women receiving a higher concentration of bupivacaine and therefore a greater amount of local anaesthetic agent during labour were significantly more likely to have an instrumental delivery with Kielland's rotational forceps (p < 0.01). Those women receiving a lower concentration and smaller amount of bupivacaine were significantly more likely to have an instrumental delivery with Neville‐Barnes forceps (p < 0.05). This provides evidence to support the theory that epidural analgesia may contribute to inadequate rotation of the presenting fetal part due to weakened pelvic floor muscles and that this is more likely to occur when higher concentrations of bupivacaine are used and a greater degree of motor block occurs.</description><identifier>ISSN: 0003-2409</identifier><identifier>EISSN: 1365-2044</identifier><identifier>DOI: 10.1111/j.1365-2044.1994.tb04362.x</identifier><identifier>PMID: 7864327</identifier><identifier>CODEN: ANASAB</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Abdominal surgery. Urology. Gynecology. Obstetrics ; Anaesthetic techniques, regional ; Anesthesia ; Anesthesia depending on type of surgery ; Anesthesia, Epidural - methods ; Anesthesia, Obstetrical - methods ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Bupivacaine - administration & dosage ; Delivery, Obstetric - methods ; Dose-Response Relationship, Drug ; epidural Anaesthesia ; Extraction, Obstetrical ; Female ; Fentanyl - administration & dosage ; Humans ; Labor, Obstetric ; Medical sciences ; obstetric ; Patient Satisfaction ; Pregnancy ; Prospective Studies ; Single-Blind Method</subject><ispartof>Anaesthesia, 1994-12, Vol.49 (12), p.1087-1090</ispartof><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4527-cf913d7266c58b6a2ecf66495db1925b6011ab3d067c36898f06b40ede06e6033</citedby><cites>FETCH-LOGICAL-c4527-cf913d7266c58b6a2ecf66495db1925b6011ab3d067c36898f06b40ede06e6033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2044.1994.tb04362.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2044.1994.tb04362.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3352102$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7864327$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stoddart, A. P.</creatorcontrib><creatorcontrib>Nicholson, K. E. A.</creatorcontrib><creatorcontrib>Popham, P. A.</creatorcontrib><title>Low dose bupivacaine/fentanyl epidural infusions in labour and mode of delivery</title><title>Anaesthesia</title><addtitle>Anaesthesia</addtitle><description>Summary
The aim of this study was to determine the effect on the instrumental delivery rate of two different concentrations of bupivacaine combined with fentanyl in epidural infusions during labour. Only primiparous women in whom a spontaneous vaginal delivery was anticipated, were included in the study. Those women receiving a higher concentration of bupivacaine and therefore a greater amount of local anaesthetic agent during labour were significantly more likely to have an instrumental delivery with Kielland's rotational forceps (p < 0.01). Those women receiving a lower concentration and smaller amount of bupivacaine were significantly more likely to have an instrumental delivery with Neville‐Barnes forceps (p < 0.05). This provides evidence to support the theory that epidural analgesia may contribute to inadequate rotation of the presenting fetal part due to weakened pelvic floor muscles and that this is more likely to occur when higher concentrations of bupivacaine are used and a greater degree of motor block occurs.</description><subject>Abdominal surgery. Urology. Gynecology. Obstetrics</subject><subject>Anaesthetic techniques, regional</subject><subject>Anesthesia</subject><subject>Anesthesia depending on type of surgery</subject><subject>Anesthesia, Epidural - methods</subject><subject>Anesthesia, Obstetrical - methods</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Bupivacaine - administration & dosage</subject><subject>Delivery, Obstetric - methods</subject><subject>Dose-Response Relationship, Drug</subject><subject>epidural Anaesthesia</subject><subject>Extraction, Obstetrical</subject><subject>Female</subject><subject>Fentanyl - administration & dosage</subject><subject>Humans</subject><subject>Labor, Obstetric</subject><subject>Medical sciences</subject><subject>obstetric</subject><subject>Patient Satisfaction</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>Single-Blind Method</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqVkEtrGzEURkVpSd20P6EgSuluJnqNNNNVTUibgGk27VrocQUy8siVPEn87zPGg_fV5gq-cx8chL5Q0tL53WxbymXXMCJES4dBtAdLBJesfXmDVpfoLVoRQnjDBBneow-1bgmhrKf9FbpSvRScqRV63ORn7HMFbKd9fDLOxBFuAowHMx4Thn30UzEJxzFMNeaxzj-cjM1TwWb0eJc94BywhxSfoBw_onfBpAqflnqN_v68-3N732wefz3crjeNEx1TjQsD5V4xKV3XW2kYuCClGDpv6cA6KwmlxnJPpHJc9kMfiLSCgAciQRLOr9G389x9yf8mqAe9i9VBSmaEPFWtlOoYVXQGv59BV3KtBYLel7gz5agp0SebeqtPyvRJmT7Z1ItN_TI3f162THYH_tK66Jvzr0tuqjMpFDO6WC8Y5_MNhM3YjzP2HBMc_-MAvf69vqOkV_wVt0SRjw</recordid><startdate>199412</startdate><enddate>199412</enddate><creator>Stoddart, A. P.</creator><creator>Nicholson, K. E. A.</creator><creator>Popham, P. A.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199412</creationdate><title>Low dose bupivacaine/fentanyl epidural infusions in labour and mode of delivery</title><author>Stoddart, A. P. ; Nicholson, K. E. A. ; Popham, P. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4527-cf913d7266c58b6a2ecf66495db1925b6011ab3d067c36898f06b40ede06e6033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Abdominal surgery. Urology. Gynecology. Obstetrics</topic><topic>Anaesthetic techniques, regional</topic><topic>Anesthesia</topic><topic>Anesthesia depending on type of surgery</topic><topic>Anesthesia, Epidural - methods</topic><topic>Anesthesia, Obstetrical - methods</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Bupivacaine - administration & dosage</topic><topic>Delivery, Obstetric - methods</topic><topic>Dose-Response Relationship, Drug</topic><topic>epidural Anaesthesia</topic><topic>Extraction, Obstetrical</topic><topic>Female</topic><topic>Fentanyl - administration & dosage</topic><topic>Humans</topic><topic>Labor, Obstetric</topic><topic>Medical sciences</topic><topic>obstetric</topic><topic>Patient Satisfaction</topic><topic>Pregnancy</topic><topic>Prospective Studies</topic><topic>Single-Blind Method</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stoddart, A. P.</creatorcontrib><creatorcontrib>Nicholson, K. E. A.</creatorcontrib><creatorcontrib>Popham, P. A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Anaesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stoddart, A. P.</au><au>Nicholson, K. E. A.</au><au>Popham, P. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low dose bupivacaine/fentanyl epidural infusions in labour and mode of delivery</atitle><jtitle>Anaesthesia</jtitle><addtitle>Anaesthesia</addtitle><date>1994-12</date><risdate>1994</risdate><volume>49</volume><issue>12</issue><spage>1087</spage><epage>1090</epage><pages>1087-1090</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><coden>ANASAB</coden><abstract>Summary
The aim of this study was to determine the effect on the instrumental delivery rate of two different concentrations of bupivacaine combined with fentanyl in epidural infusions during labour. Only primiparous women in whom a spontaneous vaginal delivery was anticipated, were included in the study. Those women receiving a higher concentration of bupivacaine and therefore a greater amount of local anaesthetic agent during labour were significantly more likely to have an instrumental delivery with Kielland's rotational forceps (p < 0.01). Those women receiving a lower concentration and smaller amount of bupivacaine were significantly more likely to have an instrumental delivery with Neville‐Barnes forceps (p < 0.05). This provides evidence to support the theory that epidural analgesia may contribute to inadequate rotation of the presenting fetal part due to weakened pelvic floor muscles and that this is more likely to occur when higher concentrations of bupivacaine are used and a greater degree of motor block occurs.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>7864327</pmid><doi>10.1111/j.1365-2044.1994.tb04362.x</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley-Blackwell Journals; MEDLINE; Free E-Journal (出版社公開部分のみ）; Alma/SFX Local Collection |
| subjects | Abdominal surgery. Urology. Gynecology. Obstetrics Anaesthetic techniques, regional Anesthesia Anesthesia depending on type of surgery Anesthesia, Epidural - methods Anesthesia, Obstetrical - methods Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Bupivacaine - administration & dosage Delivery, Obstetric - methods Dose-Response Relationship, Drug epidural Anaesthesia Extraction, Obstetrical Female Fentanyl - administration & dosage Humans Labor, Obstetric Medical sciences obstetric Patient Satisfaction Pregnancy Prospective Studies Single-Blind Method |
| title | Low dose bupivacaine/fentanyl epidural infusions in labour and mode of delivery |
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