Influence of diferent concentrations of bupivacaine and levobupivacaine with fentanyl on labour in epidural analgesia: retrospective view
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 labour and delivery were assessed according to EDA protocol used.
Results: We found statistically significant prolongation of the second stage of labour and increase 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 protocols provided clinically efficient analgesia. 0.2 % levobupivacaine with 1 µg of fentanyl/ml of local anaesthetic 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.
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References
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