The documents on the median effective concentration of local analgesic were many in primiparas during labor analgesia. However, the studies were fewer in multiparas. To explore the analgesic requirements in multiparas during epidural labor analgesia, we investigated the median effective concentration of ropivacaine with 2 μg/mL fentanyl for epidural labor analgesia in multiparas.Sixty-two women were recruited and assigned to the primipara group and multipara group in this prospective study. All the parturients received ropivacaine combined with 2 μg/mL fentanyl for epidural labor analgesia. The concentration of ropivacaine was determined by the up and down method and an initial concentration was set as 0.1% with a 0.01% interval. Effective analgesia was defined as the visual analog scale (VAS) ≤3 within 30 minutes after epidural administration when cervical dilatation is about 2 cm. The median effective concentration of ropivacaine was calculated by the up and down sequential method. The pain intensity was assessed using VAS. Hemodynamic parameters, the labor stages, and neonatal Apgar scores were recorded. Umbilical artery blood was drawn to analyze. The side effects, if any, were also recorded.The median effective concentration of ropivacaine was 0.057% (95% confidence interval [CI], 0.051-0.064%) in primiparas during epidural labor analgesia, and 0.068% (95% CI, 0.063-0.072%) in multiparas during epidural labor analgesia, there was significant difference between the groups (P = .02).This study indicated that the median effective concentration of ropivacaine with fentanyl for epidural labor analgesia was 0.068% (95% CI, 0.063-0.072%) and increased in multiparas compared with the primiparas (www.chictr.org.cn, registration number: ChiCTR-1800016486).
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http://dx.doi.org/10.1097/MD.0000000000018673 | DOI Listing |
BMC Public Health
January 2025
School of Nursing, Medical School, Shenzhen University, Shenzhen, China.
Background: A significant number of primiparous women lack awareness of labor epidural analgesia, resulting in lower acceptance of labor epidural analgesia. Additional prenatal education may help primiparas understand labor epidural analgesia and increase labor epidural analgesia rates. This randomized controlled trial (RCT) will evaluate the effects of an online and offline prenatal labor epidural analgesia education program for primiparas to improve their labor epidural analgesia rate and to reduce their misunderstanding of labor epidural analgesia and fear of birth.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
January 2025
Department of Anesthesiology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Medical University, Fujian, Fuzhou 350001, China.
Background: Epidural labor analgesia (ELA) is widely and safely used for labor pain relief. However, it remains unclear whether ELA affects maternal and neonatal outcomes in women suffering from preeclampsia.
Methods: This study reviewed the medical records of women with preeclampsia at ≥ 28 weeks of gestation between January 2015 and December 2020.
J Cardiothorac Vasc Anesth
October 2024
Department of Anesthesiology, Missoula Anesthesiology and The International Heart Institute of Montana, Missoula, MT.
Moderate to severe pain after cardiac surgery is relatively common, which increases the risk of postoperative cardiopulmonary complications and delays hospital discharge. Opioids have been useful agents for postoperative pain control after cardiac surgery, but are associated with serious adverse effects. As a result, multimodal analgesia has been adopted widely to decrease reliance on opioids for treating postoperative pain, reduce opioid-related adverse effects, and promote early recovery.
View Article and Find Full Text PDFBr J Anaesth
January 2025
Department of Anaesthesia and Pain Medicine, West Suffolk Hospital NHS Trust, Bury St. Edmunds, UK. Electronic address:
Cureus
December 2024
Pediatric Surgery, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Postoperative pain in children leads to an immense stress response than adults, leading to an increased hospital stay and "pain memory." Caudal epidural anesthesia is one of the most reliable, popular, and safe techniques that provide proper analgesia for infra-umbilical surgeries. A combination of local anesthetics and opioids reduces the dose-related adverse effects of each drug independently.
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