EurekaMag.com logo
+ Site Statistics
References:
52,725,316
Abstracts:
28,411,598
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on Google+Follow on Google+
Follow on LinkedInFollow on LinkedIn

+ Translate

Effect of combined spinal-epidural ambulatory labor analgesia on balance


Anesthesiology 91(2): 436-441
Effect of combined spinal-epidural ambulatory labor analgesia on balance
Background: Low-dose combined spinal-epidural analgesia in labor has proved popular with women because lower-limb motor power is preserved, allowing ambulation. However, there has been debate about the safety of allowing women to walk following low-dose regional analgesia because of somatosensory impairment. The authors undertook a prospective controlled observational study using computerized dynamic posturography to examine balance function in pregnant women after combined spinal-epidural analgesia. Methods: The authors performed posturographic testing on 44 women in labor after institution of regional analgesia and compared them with a control group of 44 pregnant women. A separate group of six women were tested both before and after combined spinal-epidural analgesia. Results: Neurologic examination after regional analgesia showed two parturients (4%) to have motor weakness (excluded from posturography). Four women (9%) had clinical dorsal column sensory loss; these women all completed posturography. The spinal-epidural analgesia group showed a small, statistically significant reduction in one of six posturographic sensory-organization tests; however, this difference was functionally minor. There were no other differences in posturography between the control and spinal-epidural groups. Similar results were found in the paired study, in which there was minimal change in balance function after spinal-epidural analgesia. Conclusions: This is the first study to objectively examine the effect of spinal-epidural analgesia on balance function. Using computerized dynamic posturography, the authors were unable to find any functional impairment of balance function after spinal-epidural ambulatory analgesia in women in labor who had no clinical evidence of motor block.


Accession: 010519676

PMID: 10443607

DOI: 10.1097/00000542-199908000-00018



Related references

Combined spinal-epidural analgesia and epidural analgesia in labor: effect of intrathecal fentanyl vs. epidural bupivacaine as a bolus. Journal of the Medical Association of Thailand 90(7): 1368-1374, 2007

Effect of combined spinal-epidural analgesia versus epidural analgesia on labor and delivery duration. International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics 114(3): 246-250, 2011

Ambulatory combined spinal-epidural analgesia for labor. Influence of epinephrine on bupivacaine-sufentanil combination. Regional Anesthesia 22(2): 143-149, 1997

Success of spinal and epidural labor analgesia: comparison of loss of resistance technique using air versus saline in combined spinal-epidural labor analgesia technique. Anesthesiology 111(1): 165-172, 2009

Effect of Epidural Test Dose on Ambulation after a Combined Spinal Epidural Technique for Labor Analgesia. Anesthesiology Abstracts of Scientific Papers Annual Meeting ( ): Abstract No A-1053, 2002

From balanced analgesia to epidural analgesia or combined spinal-epidural analgesia for relief of labor pain. Masui. Japanese Journal of Anesthesiology 59(3): 319-327, 2010

The effect of epidural test dose on motor function after a combined spinal-epidural technique for labor analgesia. Anesthesia and Analgesia 96(4): 1167-72, Table of Contents, 2003

The effect on maternal temperature of delaying initiation of the epidural component of combined spinal-epidural analgesia for labor: a pilot study. International Journal of Obstetric Anesthesia 20(4): 312-317, 2012

A comparison of early combined spinal epidural analgesia vs epidural analgesia on labor stage duration and obstetric outcome. Anesthesiology (Hagerstown) 85(3A): A851, 1996

Comparison of epidural analgesia with combined spinal-epidural analgesia for labor: a retrospective study of 6497 cases. International Journal of Obstetric Anesthesia 17(1): 15-19, 2007