[Loco-regional analgesia with continuous peridural technique in labor. Evaluation of 4 years of experience]

Abstract

The Authors report on the results of their experience using local-regional analgesia performed with the continuous peridural technique over four years of activity with 503 pregnant women. Protocols used over the years called for morphine-fentanyl association, but bupivacaine 0.25% plus fentanyl and bupivacaine 0.125% plus fentanyl mixtures were then employed. In order to evaluate the efficiency of this procedure, the following data were recorded for each patient undergoing the analgesia: duration of labor prior to the effect of the analgesia; time to reach complete dilatation from a 3 cm dilatation; the length of time of the expulsive phase; manifestation of side effects and complications; vacuum utilization. Furthermore, Apgar scores were taken for all newborn babies at 1st and 5th minutes. The data were then compared with those recorded for a group of women with the same obstetrical characteristics who were not treated with analgesia. The comparison showed that the length of time of the dilatation phase (from 3 to 10 cms) was significantly less in the group of treated patients, while the expulsive phase was basically similar in both groups, thus showing that labor mean time had significantly decreased in the group of patients treated with analgesia. The number of vacuum births was basically the same in both groups and comparable to the data available in the literature. These were practically no side effects or complications. In conclusion, our experience confirms the fact that this method is the most reliable in terms of safety, effectiveness and acceptability on the part of women compared to any other analgesic treatment employed during labor.