Extradural diamorphine with adrenaline in labour: comparison with diamorphine and bupivacaine
| Autor: | S. Munishankarappa, M. K. Milne, M.E. Elphinstone, G.M.A. Keenan |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Epinephrine medicine.drug_class Heroin Double-Blind Method Pregnancy Statistical significance Medicine Humans Bupivacaine Pain score Labor Obstetric business.industry Local anesthetic Pain management Surgery Analgesia Epidural Anesthesiology and Pain Medicine Regional anesthesia Anesthesia Analgesia Obstetrical Female business medicine.drug |
| Zdroj: | British journal of anaesthesia. 66(2) |
| ISSN: | 0007-0912 |
| Popis: | In a randomized double-blind study of 51 primigravida, we have examined the relative efficacies of bupivacaine, diamorphine or diamorphine with adrenaline given by the extradural route for relief of pain during labour. Group 1 (n = 18) received diamorphine 5 mg in 0.9% sodium chloride 8 ml; group 2 (n = 19) received diamorphine 5 mg in 0.9% sodium chloride 8 ml with 1:200,000 adrenaline; group 3 (n = 14) received 0.375% bupivacaine 8 ml. All patients received 0.375% bupivacaine 8 ml as a supplement after the initial analgesia had subsided. Patients in all groups had satisfactory and comparable analgesia 20 min after the initial injection. However, after 60 min and up to 8 h, analgesia was superior in group 2 as assessed by linear analogue pain scores, with statistical significance at 4, 6 and 8 h. Groups 1 and 2 required bupivacaine supplements less frequently than group 3 (P less than 0.001). There were no serious adverse effects in any group, but pruritus was a feature in the diamorphine groups. Diamorphine 5 mg may be used as an alternative to bupivacaine 0.375% 8 ml in the first stage of labour and provides a longer duration of action. The addition of adrenaline 1:200,000 appears to augment both the quality and duration of analgesia. |
| Databáze: | OpenAIRE |
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