| Incidence of Cesarean Section Following a Continuous Lumbar Epidural Analgesia for Labor Pain. |
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Kyu Sik Kang, Soo Dal Kwak, Sang Chul Bae, Kyung Ho Hwang, Dong Gi Lee, Wook Park |
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Department of Anesthesiology, College of Medicine, Soon Chun Hyang University, Seoul, Korea. |
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| Abstract |
BACKGROUND
This retrospective study was subjected to evaluate a causal relation in the incidences of Cesarean section with or without epidural analgesia during labor.
METHODS
All of the subjects was divided into two groups which consisted of 394 cases wanted epidural analgesia as Epidural group and 2938 cases unwanted it as Non-epidural group. Continuous lumbar epidural analgesia was performed at L3-4 interspace with catheter advancing 3 cm cephalad when cervix was dilated to at least 3~5 cm and then patient was placed lateral decubitus or sitting posture. 0.125% bupivacaine 10 ml was injected initially via the epidural catheter and then followed by a mixture (10 ml) of bupivacaine 16.7 mg and fentanyl 16.7 microgram hourly to be infused continuously. The data were analysed using Pearson's x2 test with p<0.05 taken as a significant difference.
RESULTS
The incidence of normal spontaneous vaginal delivery and Cesarean section, the cause of alteration to Cesarean section, and gestational frequency followed by Cesarean section rate showed no significant difference between two groups. The occurrence of neonate below 7 points of Apgar score at one and five minute after Cesarean section was rather more in Non-epidural group (p<0.05) than that in Epidural group.
CONCLUSION
It is concluded that the continuous lumbar epidural analgesia with the dose of bupivacaine and fentanyl as mentioned above does not affect to Cesarean section rate during labor, which provides safe and effective for labor pain control. |
| Key Words:
Analgesics: fentanyl; Anesthetics, local: bupivacaine; Anesthetic technique, epidural: lumbar; Pain: labor |
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