Labor is the process where the cervix is prepared to allow the baby to pass from the uterine cavity to the outside world. In the ordinary course, it ends with spontaneous or instrumental vaginal delivery or cesarean section. Traditionally, the first stage in which the cervix is passively dilated in response to uterine contractions consists of the second stage in which the mother passes the baby through the vagina and the third stage, the exit of the placenta. In the first stage of labor, pain is caused by uterine contractions and pressure on the cervix. Pain is transmitted through the T10-L2 spinal nerves and is felt in the abdominal wall, waist, hips, or thighs. In the second stage, pain from the vagina and perineum is added to uterine pain. This pain is transmitted by the pudendal nerves through the S2-4 nerve roots. In this study, we aimed to investigate the effects of dural puncture epidural analgesia versus combined spinal-epidural analgesia with epidural volume extension on labor variables.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
2 µg/ml fentanyl + %0,125 bupivacaine (20 ml) to epidural
10 µg fentanyl + 2 mg bupivacaine to intrathecal 7.4 ml saline volume to epidural
Ataturk University
Erzurum, Yakutiye, Turkey (Türkiye)
Erzurum Regional Training Research Hospital
Erzurum, Yakutiye, Turkey (Türkiye)
First Epidural top-up time
Time elapsed between the end of local anesthetic injection and the return of pain \>4 on the NPRS.
Time frame: First 24 hours
Sacral analgesia time
Blockade of the S2 dermatome
Time frame: First 24 hours
Performance time
interval between skin disinfection and epidural catheter fixation to the skin
Time frame: First 24 hours
Incidence of Side Effect
maternal motor block, hypotension, pruritis, headache and fetal bradycardia
Time frame: First 24 hours
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