Enquete nationale prospective sur les alternatives a l'analgesie peridurale obstetricale

Translated title of the contribution: A national prospective survey of non-epidural methods for pain relief during labour

S. Bergeret, P. Loffredo, J. L. Bosson, M. Palot, J. Seebacher, D. Benhamou, J. F. Payen

Research output: Contribution to journalArticle

Abstract

Objective: To assess the type of an alternative technique for epidural analgesia for pain relief during labour, the reason of its choice and its efficiency. Study design: A one-year prospective survey in 34 french hospitals. Material and methods: A questionnaire was filled for each request for a non-epidural technique during labour. The data recorded the reason for this non-epidural method, the technique used, the repeated visual analog scale (VAS) pain scores before (T0) and during the treatment (T30, T60, T120,...), the maternal and foetal side effects of the method, and the maternal satisfaction. Results: 177 questionnaires were studied among the 270 collected. The lack of VAS measurements was the main reason for excluding questionnaires. Refusing the epidural by the obstetric patient was the most frequent reason for requesting a non-epidural method (39%). Five non-epidural methods were identified: nalbuphine (NAL, n = 75), sufentanil by patient-controlled analgesia (SUF, n = 44), nitrous oxide/oxygen inhalation (N2O, n = 22), pethidine (PET, n = 19), and spinal analgesia (SA, n = 17). The choice of the method was dependant on the prescriptor (midwife or anaesthetist) and of the cervical dilation. The SA group exhibited the most pain relief compared to the other groups during the treatment. No difference in pain relief was noted between the 4 groups (SUF, NAL, PET, N2O). Only in the PET group did the VAS pain score remain unchanged at T30. There were 25 maternal side effects, with a significant maternal sedation in the NAL group, and pruritus in the SA group. There were 6 respiratory depressions in infants, unrelated with the analgesic method. Maternal satisfaction was higher in the SA, SUF and N2O groups than in the PET and NAL groups. Factors explaining lack of analgesic effect (i.e. no decrease in VAS pain score more than 10 mm during the treatment) were the use of pethidine, the VAS pain score at T0 and the induced labour. Conclusion: Epidural and spinal analgesia are the most efficient methods for pain relief during labour. The analgesic effect of non-regional methods during labour is minimal, associated with some maternal side effects. Due to its lack of analgesic effect, pethidine should be avoided in this indication. (C) 2000 Editions scientifiques et medicales Elsevier SAS.

Translated title of the contributionA national prospective survey of non-epidural methods for pain relief during labour
Original languageFrench
Pages (from-to)530-539
Number of pages10
JournalAnnales francaises d'anesthesie et de reanimation
Volume19
Issue number7
DOIs
StatePublished - Jan 1 2000

Keywords

  • National survey
  • Non-epidural method
  • Obstetric

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Bergeret, S., Loffredo, P., Bosson, J. L., Palot, M., Seebacher, J., Benhamou, D., & Payen, J. F. (2000). Enquete nationale prospective sur les alternatives a l'analgesie peridurale obstetricale. Annales francaises d'anesthesie et de reanimation, 19(7), 530-539. https://doi.org/10.1016/S0750-7658(00)00248-3