Clinical Assessment of the Epidural Labor Analgesia Protocol at Hospital Universitario San Ignacio

Introduction: Neuraxial analgesia is considered standard of care for labor pain. There is evidence for the use of lower local anesthetic plus opioid concentrations in the epidural space than the ones used at Hospital Universitario San Ignacio. Because of this, we wanted to evaluate the labor analges...

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Autor Principal: Díaz Mescías, Adriana M.; Hospital Universitario San Ignacio
Otros Autores: Delgado, Carlos M.; Hospital Universitario San Ignacio, Sarmiento, Lina; Instituto Nacional de Pediatría, Ramírez Duque, Pablo; Instituto del Corazón, Pulido García, Liza Alexandra; Hospital Central de la Policía
Formato: info:eu-repo/semantics/article
Idioma: spa
Publicado: Pontificia Universidad Javeriana 2014
Materias:
Acceso en línea: http://revistas.javeriana.edu.co/index.php/vnimedica/article/view/16315
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Sumario: Introduction: Neuraxial analgesia is considered standard of care for labor pain. There is evidence for the use of lower local anesthetic plus opioid concentrations in the epidural space than the ones used at Hospital Universitario San Ignacio. Because of this, we wanted to evaluate the labor analgesia protocol currently offered at our institution.Methods: An observational study was conducted on laboring women who received bolus per request, using 8-10 cm3 of 0.1% bupivacaine plus fentanyl 2 μg/cm3. Pain scores were assessed using VAS scale at 30, 120, 240 mins and 1 h postpartum.Results: Pain scores at 30 min decreased from severe to mild; following evaluations reported pain to be in the moderate to severe range. Regarding motor block and incidence of hypotension at 30 min, our findings are higher than those reported worldwide. Side effects, route of delivery, neonatal outcomes and maternal satisfaction are similar to those found in the literature.Conclusions: The current analgesic concentration used at our hospital adequately controls labor pain after the first bolus, but fails to provide long-lasting effective analgesia afterwards, making it necessary to optimize continued pain control assessment.