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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 07 Jan 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Continuous epidural infusion of 0.0625% bupivacaine-0.0002% fentanyl during the second stage of labor. Anesthesiology. 1990 Apr;72(4):613-8.

Author(s) :

Chestnut DH, Laszewski LJ, Pollack KL, Bates JN, Manago NK, Choi WW.

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

A randomized, double-blind, placebo-controlled study was performed to evaluate the analgesic efficacy and influence of continuing an epidural infusion of 0.0625% bupivacaine-0.0002% fentanyl during the second stage of labor in nulliparous women. When the cervix was fully dilated, coded study solution was substituted for the known bupivacaine-fentanyl solution. The study solution for 29 patients was 0.0625% bupivacaine-0.0002% fentanyl; 34 patients received saline placebo. The two groups had similar pain scores during the first stage of labor. During the second stage, pain scores were significantly higher in the saline-placebo group at each 30-min interval between 60 and 150 min after the diagnosis of full cervical dilation. Similarly, there was a significant difference between the two groups in global assessment of analgesia quality during the second stage, but the difference occurred in those patients with a second-stage duration of greater than or equal to 60 min. Among the women who delivered vaginally, eleven of 28 (39%) women in the bupivacaine-fentanyl group, versus five of 34 (15%) in the saline-placebo group, had surgical perineal anesthesia for vaginal delivery (P less than .05). Six of 28 (21%) women in the bupivacaine-fentanyl group, and five of 34 (15%) in the saline-placebo group, underwent instrumental vaginal delivery (P = NS). The median duration of the second stage of labor was 53 min (range = 5-283) in the bupivacaine-fentanyl group, and 63 min (range = 16-181) in the saline-placebo group (P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

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Keywords :

➡ evidence-based medicine/midwifery ; instrumental delivery ; epidural ; dilation

Author of this record :

Cécile Loup — 07 Jan 2004
➡ latest update : Bernard Bel — 02 Dec 2007

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