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Single-shot spinal block for labour analgesia in multiparous parturients*
H Viitanen1, M Viitanen, M Heikkilä
1Department of Anaesthesiology, Central Hospital of Seinajoki, Seinajoka, Finland. hanna.viitanen@epshp.fi
Acta Anaesthesiologica Scandinavica
|July 28, 2005
Summary
Single-shot spinal block provides adequate pain relief for most multiparous women during labor. However, improvements in timing, reliability, and duration are needed for optimal intrathecal analgesia.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Pain Management
Background:
- Intrathecal analgesia (ITA) is a recognized effective method for managing labor pain.
- Single-shot spinal block was implemented in 1998 for pain relief in multiparous women.
- This study evaluates the efficacy and outcomes of routine ITA use.
Purpose of the Study:
- To assess the analgesic efficacy of single-shot spinal block in multiparous parturients.
- To evaluate obstetric and neonatal outcomes associated with this analgesia method.
- To determine maternal satisfaction with intrathecal analgesia during labor.
Main Methods:
- Prospective study of 229 consecutive multiparous parturients receiving standard ITA (bupivacaine and fentanyl).
- Monitoring included maternal vital signs, fetal heart rate, pain scores (VAS), sensory/motor block, and side-effects.
- Data collected on additional analgesia requests and duration of spinal block.
Main Results:
- Satisfactory analgesia achieved in 73% of 209 participants.
- Pain relief rated excellent by 65%; 81% would opt for it again.
- Average spinal block duration was 101 ± 34 minutes; common side-effects included pruritus (64%).
Conclusions:
- The majority of multiparous women find ITA adequate for labor pain relief.
- Modifications are suggested to enhance the timing, reliability, and duration of analgesia.
- Single-shot spinal block is a viable option, but requires optimization for consistent patient satisfaction.
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