Abstract
The use of epidural analgesia has become so widespread in recent years that many women are now requesting repeat epidural analgesia for their second or subsequent labour. This study examines the incidence of problems at insertion and of inadequate block in 71 multiparae having second epidurals compared with 150 primiparae having their first epidural. Unilateral block occurred in 6.66% of primiparae and 18.3% of multiparae (P) <0.02). There was no association between difficulty of insertion of catheter, blood in needle/catheter or paraesthesia and unilateral blockade. Epidurals were inserted at a greater dilatation (P <0.05 and there was a shorter time to delivery (P < 0.01) in the multiparous group. We conclude that unilateral block is thus more common in women receiving repeat epidurals.
Résumé
Depuis quelques années, l’analgésie épidurale obstétricale connaît tellement de succès que plusieurs parturientes en refont la demande pour leur deuxième accouchement et les accouchements subséquents. Cette étude examine l’incidence des problèmes au moment de l’insertion du cathéter et l’insuffisance du bloc chez 71 multipares à la deuxième épidurale comparativement à 150 primipares à la première épidurale. Un bloc unilatéral survient chez 6,66% des primipares et chez 18,3% des multipares (P < 0,02). On ne trouve aucune relation entre la difficulté d’insertion du cathéter, la présence de sang dans l’aiguille ou la cathéter, une parethésie et l’unilatéralité du bloc. Les épidurales sont insérées lorsque la dilatation est plus grande (P < 0,05) et le délai précédant l’accouchement est plus court (P < 0,01) dans le groupe des multipares. Nous concluons que le bloc unilatéral survient plus souvent chez les femmes qui reçoivent une deuxième épidurale.
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Withington, D.E., Weeks, S.K. Repeat epidural analgesia and unilateral block. Can J Anaesth 41, 568–571 (1994). https://doi.org/10.1007/BF03009993
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DOI: https://doi.org/10.1007/BF03009993