Efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturient
Background: Establishing an epidural in an agitated laboring woman can be challenging. The ideal pain control technique in such a situation should be effective, fast acting, and short lived. We assessed the efficacy of inhalational methoxyflurane (Penthrox™) analgesia as bridging analgesia for epidu...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2015-01-01
|
| Series: | Saudi Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2015;volume=9;issue=4;spage=370;epage=375;aulast=Anwari |
| _version_ | 1818935578551386112 |
|---|---|
| author | Jamil S Anwari Laith Khalil Abdullah S Terkawi |
| author_facet | Jamil S Anwari Laith Khalil Abdullah S Terkawi |
| author_sort | Jamil S Anwari |
| collection | DOAJ |
| description | Background: Establishing an epidural in an agitated laboring woman can be challenging. The ideal pain control technique in such a situation should be effective, fast acting, and short lived. We assessed the efficacy of inhalational methoxyflurane (Penthrox™) analgesia as bridging analgesia for epidural placement. Materials and Methods: Sixty-four laboring women who requested epidural analgesia with pain score of ≥7 enrolled in an observational study, 56 of which completed the study. The parturients were instructed to use the device prior to the onset of uterine contraction pain and to stop at the peak of uterine contraction, repeatedly until epidural has been successfully placed. After each (methoxyflurane inhalation-uterine contraction) cycle, pain, Richmond Agitation Sedation Scale (RASS), nausea and vomiting were evaluated. Maternal and fetal hemodynamics and parturient satisfaction were recorded. Results: The mean baseline pain score was 8.2 ± 1.5 which was reduced to 6.2 ± 2.0 after the first inhalation with a mean difference of 2.0 ± 1.1 (95% confidence interval 1.7-2.3, P < 0.0001), and continued to decrease significantly over the study period (P < 0.0001). The RASS scores continuously improved after each cycle (P < 0.0001). Only 1 parturient from the cohort became lightly sedated (RASS = −1). Two parturients vomited, and no significant changes in maternal hemodynamics or fetal heart rate changes were identified during treatment. 67% of the parturients reported very good or excellent satisfaction with treatment. Conclusion: Penthrox™ provides rapid, robust, and satisfactory therapy to control pain and restlessness during epidural placement in laboring parturient. |
| first_indexed | 2024-12-20T05:22:24Z |
| format | Article |
| id | doaj.art-2f1c7d9e5c294dbb9711eab4389a5e40 |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-12-20T05:22:24Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-2f1c7d9e5c294dbb9711eab4389a5e402022-12-21T19:51:58ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2015-01-019437037510.4103/1658-354X.159457Efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturientJamil S AnwariLaith KhalilAbdullah S TerkawiBackground: Establishing an epidural in an agitated laboring woman can be challenging. The ideal pain control technique in such a situation should be effective, fast acting, and short lived. We assessed the efficacy of inhalational methoxyflurane (Penthrox™) analgesia as bridging analgesia for epidural placement. Materials and Methods: Sixty-four laboring women who requested epidural analgesia with pain score of ≥7 enrolled in an observational study, 56 of which completed the study. The parturients were instructed to use the device prior to the onset of uterine contraction pain and to stop at the peak of uterine contraction, repeatedly until epidural has been successfully placed. After each (methoxyflurane inhalation-uterine contraction) cycle, pain, Richmond Agitation Sedation Scale (RASS), nausea and vomiting were evaluated. Maternal and fetal hemodynamics and parturient satisfaction were recorded. Results: The mean baseline pain score was 8.2 ± 1.5 which was reduced to 6.2 ± 2.0 after the first inhalation with a mean difference of 2.0 ± 1.1 (95% confidence interval 1.7-2.3, P < 0.0001), and continued to decrease significantly over the study period (P < 0.0001). The RASS scores continuously improved after each cycle (P < 0.0001). Only 1 parturient from the cohort became lightly sedated (RASS = −1). Two parturients vomited, and no significant changes in maternal hemodynamics or fetal heart rate changes were identified during treatment. 67% of the parturients reported very good or excellent satisfaction with treatment. Conclusion: Penthrox™ provides rapid, robust, and satisfactory therapy to control pain and restlessness during epidural placement in laboring parturient.http://www.saudija.org/article.asp?issn=1658-354X;year=2015;volume=9;issue=4;spage=370;epage=375;aulast=AnwariEpidural analgesialabor painmethoxyflurane inhalation |
| spellingShingle | Jamil S Anwari Laith Khalil Abdullah S Terkawi Efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturient Saudi Journal of Anaesthesia Epidural analgesia labor pain methoxyflurane inhalation |
| title | Efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturient |
| title_full | Efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturient |
| title_fullStr | Efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturient |
| title_full_unstemmed | Efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturient |
| title_short | Efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturient |
| title_sort | efficacy of the methoxyflurane as bridging analgesia during epidural placement in laboring parturient |
| topic | Epidural analgesia labor pain methoxyflurane inhalation |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2015;volume=9;issue=4;spage=370;epage=375;aulast=Anwari |
| work_keys_str_mv | AT jamilsanwari efficacyofthemethoxyfluraneasbridginganalgesiaduringepiduralplacementinlaboringparturient AT laithkhalil efficacyofthemethoxyfluraneasbridginganalgesiaduringepiduralplacementinlaboringparturient AT abdullahsterkawi efficacyofthemethoxyfluraneasbridginganalgesiaduringepiduralplacementinlaboringparturient |