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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
ORIGINAL ARTICLES ANESTHESIOLOGY
Minerva Anestesiologica 1999 October;65(10):711-5
Epidural analgesia for painless delivery. Our experience
Rizzo D. 1, Giustiniano E. 1, Cascini V. 2
1 Casa di Cura Cascini, Belvedere Marittimo (Cosenza), Servizio di Anestesia e Rianimazione;
2 Casa di Cura Cascini, Belvedere Marittimo (Cosenza), Responsabile Reparto Ostetricia e Ginecologia
Background. We know that a stress condition causes hormonal responses (cortisol, prolactin, TSH, ACTH, catecholamines, β-endorphines). This hormonal “storm” causes metabolic and haemodynamic changes that can get worse postoperative outcome as well as birth. Analgesia for labour is an anesthesiological procedure which spreading in Italy resulted very difficult, for instance, especially in southern Italy, “old popular believes” (such as paralysis risk after lumbar puncture, Post-Dural Puncture Headache (PDPH) and the confusion between epidural and subdural anesthesia).
Methods. In front of these problems we report our experience in this field. Experimental plan: in our retrospective study we examined painless labour cases and we compared them with natural labour cases without analgesia. Environment: women of this study were pregnant admitted in obstetrics department of our hospital at the end of pregnancy. Patients: pregnant women who wanted epidural analgesia were 50 (group A); data group A were compared with data of 50 pregnant women who refused analgesia (group B). Technique: beginning labour, when cervical dilatation was 3 cm and foetal head was going down we performed epidural puncture and positioned, catheter in epidural space giving opiate and local anesthetic drugs using “top-up” method. Data: we compared APGAR-score after birth and the judgement expressed by women of the two groups.
Results and conclusions. APGAR-score in new-borns with epidural analgesia in higher than new-born without epidural analgesia; furthermore, patients who choose painless labour expressed a better judgement than women who refused epidural analgesia.