SINGLE SPACE COMBINED SPINAL-EXTRADURAL TECHNIQUE FOR ANALGESIA IN LABOUR

We have used the single space combined spinal-extradural technique for mothers requesting analgesia in labour. Intrathecal plain bupivacaine 5 mg produced a median time to analgesia of 3 min. There was inadequate abdominal analgesia after 10min in 16% of recipients, although all had good perineal an...

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Bibliographic Details
Published in:British journal of anaesthesia : BJA 1993-10, Vol.71 (4), p.499-502
Main Authors: STACEY, R.G.W., WATT, S., KADIM, M.Y., MORGAN, B.M.
Format: Article
Language:English
Subjects:
Abdominal surgery. Urology. Gynecology. Obstetrics
Adult
anaesthesia: obstetric
anaesthetic techniques: regional
anaesthetic techniques: regional, spinal, extradural
Analgesia, Epidural - methods
Analgesia, Obstetrical - methods
Anesthesia
Anesthesia depending on type of surgery
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Bupivacaine
extradural
Female
Humans
Labor, Obstetric
Medical Audit
Medical sciences
Pregnancy
Prospective Studies
spinal
Time Factors
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Summary:We have used the single space combined spinal-extradural technique for mothers requesting analgesia in labour. Intrathecal plain bupivacaine 5 mg produced a median time to analgesia of 3 min. There was inadequate abdominal analgesia after 10min in 16% of recipients, although all had good perineal analgesia. The median height of block was T8 (range T4-L2) and mean duration of analgesia 72 (SD 21) min. Hypotension occurred in two of 30 mothers, but responded to fluids and ephedrine. There were no post-spinal headaches. This technique is suitable for those parturients requesting analgesia in active labour who may not have time to achieve extradural analgesia before delivery. The extradural catheter is used to improve analgesia if the subarachnoid block is inadequate, or if labour continues beyond the duration of the subarachnoid block. (Br. J. Anaesth. 1993; 71: 499–502)
ISSN:0007-0912
1471-6771
DOI:10.1093/bja/71.4.499