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Clinical Trial
. 1999;50(3):129-36.

Prospective, randomized comparison of epidural and combined spinal epidural analgesia during labor

M Van de Velde  1 , K Mignolet, E Vandermeersch, A Van Assche
Affiliations
  • PMID: 10529851
Clinical Trial

Prospective, randomized comparison of epidural and combined spinal epidural analgesia during labor

M Van de Velde et al. Acta Anaesthesiol Belg. 1999.

Abstract

The analgesic efficacy and incidence of maternal, fetal and neonatal side-effects of combined spinal epidural (CSE) and epidural (EPI) analgesia, using a mixture of bupivacaine 0.125%, epinephrine (1.25 micrograms.ml-1) and sufentanil (0.75 microgram.ml-1) for the relief of labor pain, were randomly and prospectively compared in 110 parturients. A 29 gauge Whitacre tip spinal needle was used to perforate the dura in CSE patients. Compared to EPI, CSE resulted in rapid (326 +/- 22 vs 766 +/- 79 sec, p < 0.05), excellent analgesia, using less bupivacaine (23.5 +/- 2.3 vs 33.9 +/- 2.9 mg, p < 0.05) and sufentanil (12.5 +/- 1.0 vs 16.5 +/- .7 micrograms, p < 0.05). A tendency to improved patient satisfaction in the CSE group was observed. The incidence of maternal or neonatal side effects was similar in both groups. No PDPH was observed. We conclude that CSE analgesia results in excellent pain relief during labor with immediate gratification as compared to epidural analgesia.

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