TY - JOUR
T1 - The Effects of Prolonged Ambulation on Labor with Epidural Analgesia
AU - Frenea, Stéphane
AU - Chirossel, Christine
AU - Rodriguez, Raphaël
AU - Baguet, Jean Philippe
AU - Racinet, Claude
AU - Payen, Jean Francois
PY - 2004/1
Y1 - 2004/1
N2 - Ambulation during labor is becoming more popular, although its impact on the progress of labor and on pain intensity remains unclear. We wondered whether prolonged ambulation with epidural analgesia had a possible effect on duration of labor and pain. In this prospective, randomized trial, 61 parturients with uncomplicated term pregnancies were allocated to be recumbent (n = 31) or to ambulate (n = 30). Epidural analgesia was provided with intermittent administrations of 0.08% bupivacaine-epinephrine plus 1 μg/mL of sufentanil. Of the 30 women assigned to the ambulatory group, 25 actually walked. Their ambulating time was 64 ± 34 min (mean ± SD), i.e., 29% ± 16% of the first stage. There were no differences between the two groups in the length of labor and in pain visual analog scale scores. However, the ambulatory group received smaller doses of bupivacaine (6.4 ± 2.2 mg/h versus 8.4 ± 3.6 mg/h; P = 0.01) and of oxytocin (6.0 ± 3.7 mUI/min versus 10.2 ± 8.8 mUI/min; P < 0.05). A greater ability to void was also found in the ambulatory group (P < 0.01). Although the duration of labor and pain relief was unchanged, these findings support that ambulation during labor may be advantageous.
AB - Ambulation during labor is becoming more popular, although its impact on the progress of labor and on pain intensity remains unclear. We wondered whether prolonged ambulation with epidural analgesia had a possible effect on duration of labor and pain. In this prospective, randomized trial, 61 parturients with uncomplicated term pregnancies were allocated to be recumbent (n = 31) or to ambulate (n = 30). Epidural analgesia was provided with intermittent administrations of 0.08% bupivacaine-epinephrine plus 1 μg/mL of sufentanil. Of the 30 women assigned to the ambulatory group, 25 actually walked. Their ambulating time was 64 ± 34 min (mean ± SD), i.e., 29% ± 16% of the first stage. There were no differences between the two groups in the length of labor and in pain visual analog scale scores. However, the ambulatory group received smaller doses of bupivacaine (6.4 ± 2.2 mg/h versus 8.4 ± 3.6 mg/h; P = 0.01) and of oxytocin (6.0 ± 3.7 mUI/min versus 10.2 ± 8.8 mUI/min; P < 0.05). A greater ability to void was also found in the ambulatory group (P < 0.01). Although the duration of labor and pain relief was unchanged, these findings support that ambulation during labor may be advantageous.
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U2 - 10.1213/01.ANE.0000090317.01876.D9
DO - 10.1213/01.ANE.0000090317.01876.D9
M3 - Article
C2 - 14693624
AN - SCOPUS:0347993860
SN - 0003-2999
VL - 98
SP - 224
EP - 229
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 1
ER -