Abstract
Seven women received labor analgesia with 0.125% bupivacaine and fentanyl 2 μg/mL delivered through a new generation of over-the-needle 23-gauge spinal catheters.
The first patient was managed with intermittent bolus injections but inadequate pain
control prompted a conversion to a continuous infusion for subsequent patients. One
patient developed a postdural puncture headache following catheterization for 5 h, but there were no headaches in those who had an indwelling catheter for 8 h or longer. In one patient the catheter was also used to provide anesthesia for cesarean
delivery with 0.5% bupivacaine and fentanyl 20 μg. The largest drop in mean arterial blood pressure was 34% which occurred during
the intermittent dosing period in the first patient. The mean blood pressure decrease
was <25% in the remaining patients. One patient with labor lasting over 17 h developed pain and paresthesia that resolved in 24 h without treatment. Two patients had motor block that necessitated a temporary reduction
in rate or discontinuation of the infusion. The continuous spinal catheter appeared
to be acceptable to patients but the optimal choice of drugs, concentration, and mode
of administration remains to be determined.
Keywords
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References
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Article info
Publication history
Published online: September 12, 2011
Accepted:
July 17,
2011
Footnotes
☆Presented at the 43rd Annual Meeting of Society for Obstetric Anesthesia and Perinatology, April 13–17, 2011, Henderson, Nevada.
Identification
Copyright
Published by Elsevier Inc.
