A Randomized Trial of Intrapartum Analgesia in Women With Severe Preeclampsia
作者:
Barbara Head,
John Owen,
Robert Vincent,
Grace Shih,
David Chestnut,
John Hauth,
期刊:
Obstetrics & Gynecology
(OVID Available online 2002)
卷期:
Volume 99,
issue 3
页码: 452-457
ISSN:0029-7844
年代: 2002
出版商: OVID
数据来源: OVID
摘要:
OBJECTIVETo estimate whether the cesarean delivery rate differs between women with severe preeclampsia who receive intrapartum epidural analgesia versus patient-controlled intravenous opioid analgesia.METHODSWomen with severe preeclampsia at at least 24 weeks' gestation were randomly assigned to receive either intrapartum epidural (n= 56) versus patient-controlled intravenous opioid analgesia (n= 60), and each was administered by a standardized protocol. The sample size was selected to have 80% power to detect at least a 50% difference in the predicted intergroup cesarean delivery rates. Data were analyzed by intent to treat.RESULTSSelected maternal characteristics and neonatal outcomes were similar in the two groups. The cesarean delivery rates in the epidural group (18%) and the patient-controlled analgesia group (12%) were similar (P= .35). Women who received epidural analgesia were more likely to require ephedrine for the treatment of hypotension (9% versus 0%,P= .02), but their infants were less likely to require naloxone at delivery (9% versus 54%,P< .001). Epidural analgesia provided significantly better pain relief as determined by a visual analogue intrapartum pain score (P< .001) and a postpartum pain management survey (P= .002).CONCLUSIONCompared with patient-controlled intravenous opioid analgesia, intrapartum epidural analgesia did not significantly increase the cesarean delivery rate in women with severe preeclampsia at our level III center, and it provided superior pain relief.
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