The Effect of Intrathecal Analgesia on the Success of External Cephalic Version
| Autor: | Maxine M. Kuroda, Jay Matut, David J. Birnbach, D. M. Thys, Amos Grunebaum, Calin Drimbarean, Joanne Campagnuolo, D. J. Stein |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
medicine.medical_specialty Sufentanil medicine.medical_treatment Intrathecal Pregnancy Breech presentation medicine Humans Breech Presentation Injections Spinal business.industry Fetal Bradycardia medicine.disease Surgery Analgesics Opioid Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia External cephalic version Analgesia Obstetrical Gestation Abdomen Female business medicine.drug |
| Zdroj: | Anesthesia & Analgesia. 93:410-413 |
| ISSN: | 0003-2999 |
| DOI: | 10.1213/00000539-200108000-00035 |
| Popis: | UNLABELLED External cephalic version (ECV), the procedure whereby a fetus in the breech position is converted to vertex, is often performed to avoid an operative delivery. Potential benefits of epidural and spinal anesthesia for this procedure are controversial. Several previous studies have evaluated the use of epidural anesthesia with varying results. We sought to determine whether analgesia produced by subarachnoid sufentanil would safely improve the success of ECV. Patients who received subarachnoid analgesia (n = 20) were compared with those who did not (n = 15) in regard to success of ECV, level of pain during ECV, and satisfaction. ECV was successful in 21 patients (60%), with more frequent success in women who received spinal analgesia as compared with those who did not (80% vs 33%, respectively; P = 0.005). Patients who received spinals also reported smaller pain scores and were more satisfied with ECV. None of the women who received spinal analgesia developed a postdural puncture headache, and the only case of fetal bradycardia occurred in a patient who did not receive spinal analgesia. More profound patient comfort after spinal analgesia may have permitted greater manipulation of the abdomen during ECV, thus improving success rates of ECV without increasing risk. IMPLICATIONS The success of external cephalic version (ECV) was compared in women who received spinal analgesia and those who did not. Successful ECV occurred more frequently in those women who received spinal analgesia. Because term singleton pregnancies associated with breech position usually require cesarean delivery, an increase in success of ECV may decrease the number of cesarean deliveries performed. |
| Databáze: | OpenAIRE |
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