Comparison of Spinal Anesthesia with Pethidine and Epidural Anesthesia with Bupivacaine in Pain Relief of Labor: A Clinical Trial

Document Type : Original Article

Authors

1 Associate Professor, Department of Anesthesiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

2 Associate Professor, Department of Obstetrics and Gynecology, Research Center of Abnormal Uterine Bleeding, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

3 Associate Professor, Department of Community Medicine, Research Center of Social Determinants of Health, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

4 Assistant Professor, Department of Anesthesiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

5 General Practitioner, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

Abstract

Introduction: Labor pain during normal vaginal delivery is one of the most severe pain conditions that women experience during their life and have unpleasant effects on mothers and their fetuses. So, it is necessary to be familiar with power of decrease of pain and complications of different ways are used for labor pain relief.
This study was performed aimed to assess the side effects, outcomes and pain relief rate of spinal and epidural anesthesia in vaginal delivery.
Methods: This clinical trial was performed in 2013 on 50 patients hospitalized in Amir hospital of Semnan, Iran. An intravenous catheter was inserted for all patients and 500-1000 cc serum Ringer infused. The patients were divided into two groups of spinal and epidural anesthesia. When the cervix dilated 4 cm, in first group 10 mg metoclopramide and 8 mg dexamethasone were injected intravenously, and then 25 mg pethidine plus 1.5 cc Dextrose 10% (totally 2cc) were injected in subarachnoid space. In second group, a bolus of 15 cc of 0.125% bupivacaine plus 10 microgram sufentanil (2cc) in 3 divided doses every 5 minutes were injected in epidural space. The pain score, vital signs, side effects, muscular tone, Apgar score and patients' satisfaction were evaluated. Data were analyzed by SPSS software (version 16), Kolmogorov-Smirnov, t-test Mann-Whitney, chi-square and Fisher exact tests. P value less than 0.05 was considered significant.
Results: During all recorded times, the pain severity was less in the group received pethidine. The level of satisfaction was more in spinal group (p<0.001). None of the patients in spinal group had nausea, vomiting, itching and hemodynamic instability.
Conclusion: Spinal administration of pethidine provides good pain relief with less muscular tone disturbance. This method has rare and predictable side effects and has no late side effects and respiratory depression.

Keywords

References

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