Comparison of parturient – controlled remifentanil with epidural bupivacain and sufentanil for labour analgesia: Randomised controlled trial

Název česky Srovnání rodičkou řízeného podání remifentanilu s epidurální analgezií bupivakainem a sufentanilem u porodu: randomizovaná studie
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ŠTOURAČ Petr HARAZIM Hana STODŮLKOVÁ Marta HUSER Martin KŘIKAVA Ivo JANKŮ Petr HAKLOVA Olga HAKL Lubomír ŠTOUDEK Roman GÁL Roman ŠEVČÍK Pavel

Rok publikování 2014
Druh Článek v odborném periodiku
Časopis / Zdroj Biomedical papers of the Medical Faculty of the University Palacký, Olomouc Czech Republic
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www http://biomed.papers.upol.cz/pdfs/bio/2014/02/11.pdf
Doi http://dx.doi.org/10.5507/bp.2012.073
Obor Gynekologie a porodnictví
Klíčová slova obstetric analgesia; epidural analgesia; parturient-controlled intravenous analgesia; remifentanil
Přiložené soubory
Popis Epidural analgesia (EA) has significant contraindications including coagulation disorders and parturient refusal. One alternative is intravenous self-administered analgesia using the ultra short-acting opioid remifentanil (rPCA). We compared the efficiency and safety of standard epidural analgesia with parturient-controlled intravenous analgesia using remifentanil as well as personal satisfaction. We enrolled twelve ASA I classified women with singleton pregnancy who delivered vaginally in the period 3/2010-5/2010 and who received rPCA (n=12) in standard analgesic protocol: 20 mcg boluses using PCA pump with a lockout interval of 3 min. The control group consisted of 12 pregnant women who received EA (n=12): 0.125% bupivacaine with sufentanil 0.5 mcg/mL in top-up boluses every hour until delivery. Data were acquired from standard Acute Pain Service (APS) form and patient medical records (demographic, labour course parameters), Visual Analogue Scale (VAS), Bromage Scale (BS) and adverse effects of analgesia. There were no demographic or labour course parameter differences between groups (P>0.05). The differences in VAS decrease (P=0.056) and parturient satisfaction (P=0.24) during the whole analgesia administration were statistically insignificant. The main limitation of the study was small sample and enrolment of healthy singleton pregnant women only. Remifentanil use in obstetric analgesia is a viable alternative to EA, especially in cases of EA contraindications and parturient disapproval.

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