Sequential spinal epidural analgesia for pain relief in labour: an audit of 620 parturients

This investigation was designed to evaluate sequential spinal epidural analgesia with a needle through needle technique for pain relief in labour. The spinal injection was made using a Becton Dickinson 29 gauge Quincke point needle. Bupivacaine 1 mg, sufentanil 5 microg and adrenaline 25 microg (2 ml) were injected intrathecally. Analgesia was maintained using bupivacaine 12.5 mg, sufentanil 10 microg and adrenaline 12.5 microg in a 10 ml bolus given through an epidural catheter in the epidural space. This dosage was also used for the test dose. Pain relief was obtained in less than ten minutes and lasted for a mean of 134 min. Of the 620 parturients in the investigation, 500 had a mean dose of 4.3 mg bupivacaine per hour. Hypotension and paresis were of no concern. Patient satisfaction was excellent, 85% of the parturients being very satisfied and 10% satisfied.