A comparison of spinal and epidural anesthesia for cesarean section following epidural labor analgesia: A retrospective cohort study. 2015

Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
Department of Anesthesiology, Changhua Christian Hospital, Changhua, Taiwan, ROC.

BACKGROUND This study aimed to investigate different types of regional anesthesia for cesarean section (CS) following epidural labor analgesia that could lead to various perioperative and postoperative outcomes. METHODS We retrospectively included those parturients who received epidural labor analgesia but needed subsequent CS under regional anesthesia in our institution from January 2008 to June 2012. RESULTS In all, 2341 of 6609 parturients underwent painless labor, and 334 of them converted to CS. Spinal anesthesia (SA) was used with 163 parturients, and epidural anesthesia (EA) with 96; the two groups were then compared. No high-level block or total SA was noted. The primary outcome revealed that the time from anesthesia to surgical incision and the total anesthesia time were shorter, hypotension episodes were more frequent, the rate of perioperative ephedrine administration was higher, and the rate of midazolam was lower in the SA group. With regard to secondary outcomes, the Apgar scores of the neonates recorded at 1 minute and 5 minutes and maternal satisfaction were similar. The neuraxial morphine dose was converted to parenteral morphine equivalent dose (MED), which revealed that the parturients in the spinal morphine group had lower dosages and visual analog scale (VAS) pain scores on postoperative Day 1. CONCLUSIONS For parturients with labor epidural analgesia needing CS, the use of SA led to shorter anesthetic time and lower postoperative pain scores, with lower morphine doses compared with EA. However, the high failure rate with both neuraxial techniques needs to be addressed.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000767 Anesthesia, Epidural Procedure in which an anesthetic is injected into the epidural space. Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D000773 Anesthesia, Obstetrical A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth. Anesthesia, Gynecological,Anesthesia, Obstetric,Gynecologic Anesthesia,Paracervical Block,Anesthesia, Gynecologic,Block, Paracervical,Blocks, Paracervical,Gynecological Anesthesia,Obstetric Anesthesia,Obstetrical Anesthesia,Paracervical Blocks
D000775 Anesthesia, Spinal Procedure in which an anesthetic is injected directly into the spinal cord. Anesthesias, Spinal,Spinal Anesthesia,Spinal Anesthesias
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D015331 Cohort Studies Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. Birth Cohort Studies,Birth Cohort Study,Closed Cohort Studies,Cohort Analysis,Concurrent Studies,Historical Cohort Studies,Incidence Studies,Analysis, Cohort,Cohort Studies, Closed,Cohort Studies, Historical,Studies, Closed Cohort,Studies, Concurrent,Studies, Historical Cohort,Analyses, Cohort,Closed Cohort Study,Cohort Analyses,Cohort Studies, Birth,Cohort Study,Cohort Study, Birth,Cohort Study, Closed,Cohort Study, Historical,Concurrent Study,Historical Cohort Study,Incidence Study,Studies, Birth Cohort,Studies, Cohort,Studies, Incidence,Study, Birth Cohort,Study, Closed Cohort,Study, Cohort,Study, Concurrent,Study, Historical Cohort,Study, Incidence

Related Publications

Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
October 2004, International journal of obstetric anesthesia,
Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
August 2009, Canadian journal of anaesthesia = Journal canadien d'anesthesie,
Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
March 2022, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians,
Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
August 2017, Korean journal of anesthesiology,
Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
February 2000, Acta anaesthesiologica Scandinavica,
Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
November 2005, Minerva anestesiologica,
Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
January 1984, Akusherstvo i ginekologiia,
Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
September 2006, Acta anaesthesiologica Scandinavica,
Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
August 2006, Acta anaesthesiologica Scandinavica,
Chia-Hsiang Huang, and Yi-Jer Hsieh, and Ko-Hsin Wei, and Wei-Zen Sun, and Shao-Lun Tsao
January 2008, International journal of obstetric anesthesia,
Copied contents to your clipboard!