Developing and establishing an ideal method of continuous-infusion epidural analgesia for delivery using the double-catheter method

Tokai J Exp Clin Med. 2004 Sep;29(3):79-90.

Abstract

We evaluated the efficacy of a new method of induction of epidural obstetric analgesia devised by us. The upper and lower catheters used for the epidural double-catheter method were connected to a compression-type disposable injector (Coopdech Syrinjector). 0.125 % bupivacaine + 2 microg/ml fentanyl (6 ml/h) were serially injected via the upper catheter. In the latter half of Stage 1 of labor, the same drugs were continuously infused via the lower catheter (4 ml/h). The mean number of additional drug doses administered via the upper catheter was 0.67+/-0.90 (range: 0-3) when the analgesia induction was commenced after the cervix was dilated to 8 cm in nulliparous women or 6 cm in multiparous women. The method of analgesia was found to be more effective than the conventional method (uncombined continuous infusion of a local anesthetic) for alleviating the pain of the latter half of Stage 1, and Stage 2 of labor. The mean number of additional drug doses injected via the lower catheter was 0.37+/-0.57(range: 0-2). The number of additional doses in the 49 women averaged 0.16 per hour and 1.04 per delivery. Thus, good results were obtained.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adjuvants, Anesthesia / administration & dosage
  • Adult
  • Analgesia, Obstetrical*
  • Analgesia, Patient-Controlled
  • Anesthesia, Epidural*
  • Anesthetics, Local / administration & dosage
  • Apgar Score
  • Bupivacaine / administration & dosage
  • Catheterization / instrumentation
  • Catheterization / methods*
  • Delivery, Obstetric
  • Drug Combinations
  • Female
  • Fentanyl / administration & dosage
  • Humans
  • Infant, Newborn
  • Infusions, Intravenous / instrumentation
  • Infusions, Intravenous / methods*
  • Labor Stage, First
  • Labor Stage, Second
  • Parity
  • Patient Satisfaction / statistics & numerical data
  • Pregnancy
  • Retrospective Studies

Substances

  • Adjuvants, Anesthesia
  • Anesthetics, Local
  • Drug Combinations
  • Fentanyl
  • Bupivacaine