Epidural Versus Combined Spinal and Epidural for pain relief during labour

Abstract

Our study was carried out on sixty full term primigravida with no medical or obstetric problems . Parturients with coagulopathy , sepsis at the site of injection , presence of septicaemia , massive haemorrhage or shocked parturients were excluded from our study.

Parturients were classified into three equal groups (N = 20) .

-Group I

-Group II

-Group III

received only an epidural bupivacaine 8 ml of0.25%. received an epidural bupivacaine 8 ml of 0.25% added to fentanyl 50 ug . received intrathecal fentanyl 10 ug in 1 ml and an epidural

8 ml of0.25% bupivacaine on demand.

The following data were measured and recorded :

- • Haemodynamic data ( heart rate - mean blood pressure ) which were recorded before drug injection and every two hours after block up to delivery - Pain intensity score (before the block) .

- Pain relief score ( after the block) .

- Sensory level and motor block if occurred .

- Frequency, intensity and duration of uterine contractions.

- Total doses of the drugs used,

- Duration of labour ( first , second and the total duration of labour ) .

- Intrapartum foetal monitoring .

- Cord • pH , Pa co2 , Pa 02 and HC03. were recorded .