Featured Research

from universities, journals, and other organizations

For pain control during early labor, combined spinal-epidural analgesia is best: study

Date:
February 27, 2013
Source:
International Anesthesia Research Society (IARS)
Summary:
During the first stage of labor, a combined spinal-epidural (CSE) technique offers faster and better-quality analgesia (pain relief) compared to traditional epidural analgesia, according to a new report.

During the first stage of labor, a combined spinal-epidural (CSE) technique offers faster and better-quality analgesia (pain relief) compared to traditional epidural analgesia, according to a report in the March issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

Related Articles


"A CSE technique provides more rapid onset of analgesia and more first-stage analgesia compared with a traditional epidural technique," concludes the new study, led by Dr David Gambling of Sharp Mary Birch Hospital for Women and Newborns, San Diego, Calif.

Epidural versus CSE for Pain Control during Labor The researchers compared CSE with epidural analgesia in 800 healthy women requiring pain control during labor. One group received standard epidural analgesia. In this technique, local anesthetic and pain medications are injected into the epidural space -- inside the membranes (dura) covering the spinal cord.

The other group received CSE, which starts with medications injected into the intrathecal space -- the deeper space directly around the spinal cord. After initial epidural or intrathecal injection, both groups received patient-controlled epidural analgesia. The effectiveness of pain relief, rated on a 0-to-10 scale, was compared at different times during labor and delivery.

During the first stage of labor, the typical pain score was 1.4 for women receiving CSE versus 1.9 for those receiving standard epidural analgesia. This 0.5-point difference was statistically significant. Women in the CSE group also had a shorter time to complete pain control -- an average of 11 minutes faster than the epidural group. There was no little or no difference in pain scores during the second stage of labor or at delivery.

Women in the CSE group were less likely to need additional epidural "top-up" doses to maintain good pain control. There was no significant difference in the type of delivery, with cesarean section rates of 14 to 16 percent. Side effects were also similar between groups.

Despite Differences, Both CSE and Epidural Are 'Excellent Options' Epidural analgesia has been used to provide labor pain relief for more than 40 years, with modern techniques providing better pain control with fewer side effects. Since the early 1990s, the CSE technique has become popular because it provides more rapid pain relief with less leg weakness -- the main side effect of epidural analgesia.

Despite previous studies, the relative advantages of these options for labor analgesia have been unclear. The new study is the first to directly compare epidural versus CSE for labor analgesia in a busy private maternity hospital.

The results suggest that CSE provides significantly faster and better pain relief during the first stage of labor, compared to the traditional epidural technique. The differences in pain control during early labor are small but significant, Dr Gambling and colleagues note. They write, "[W]hen one considers the fact that fewer top-up doses were required to achieve the improvement in analgesia, it would seem that on balance CSE is the superior technique for first-stage analgesia."

But that doesn't mean that CSE is always the better choice, according to an accompanying editorial by Drs Jessica L. Booth and Peter H. Pan of Wake Forest University School of Medicine. They write, "The findings…highlight that fact that both CSE and epidural analgesia are an excellent analgesic option during labor." Drs Booth and Pan believe that inconsistent results reported by previous studies "may be explained, in part, by the lack of a standard CSE or epidural technique."


Story Source:

The above story is based on materials provided by International Anesthesia Research Society (IARS). Note: Materials may be edited for content and length.


Journal Reference:

  1. David Gambling, Jonathan Berkowitz, Thomas R. Farrell, Alex Pue, Dennis Shay. A Randomized Controlled Comparison of Epidural Analgesia and Combined Spinal-Epidural Analgesia in a Private Practice Setting. Anesthesia & Analgesia, 2013; 116 (3): 636 DOI: 10.1213/ANE.0b013e31827e4e29

Cite This Page:

International Anesthesia Research Society (IARS). "For pain control during early labor, combined spinal-epidural analgesia is best: study." ScienceDaily. ScienceDaily, 27 February 2013. <www.sciencedaily.com/releases/2013/02/130227121618.htm>.
International Anesthesia Research Society (IARS). (2013, February 27). For pain control during early labor, combined spinal-epidural analgesia is best: study. ScienceDaily. Retrieved December 22, 2014 from www.sciencedaily.com/releases/2013/02/130227121618.htm
International Anesthesia Research Society (IARS). "For pain control during early labor, combined spinal-epidural analgesia is best: study." ScienceDaily. www.sciencedaily.com/releases/2013/02/130227121618.htm (accessed December 22, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, December 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Touch-Free Smart Phone Empowers Mobility-Impaired

Touch-Free Smart Phone Empowers Mobility-Impaired

Reuters - Innovations Video Online (Dec. 21, 2014) A touch-free phone developed in Israel enables the mobility-impaired to operate smart phones with just a movement of the head. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Earthworms Provide Cancer-Fighting Bacteria

Earthworms Provide Cancer-Fighting Bacteria

Reuters - Innovations Video Online (Dec. 21, 2014) Polish scientists isolate bacteria from earthworm intestines which they say may be used in antibiotics and cancer treatments. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Reuters - Innovations Video Online (Dec. 21, 2014) A team of scientists led by Danish chemist Jorn Christensen says they have isolated two chemical compounds within an existing antipsychotic medication that could be used to help a range of failing antibiotics work against killer bacterial infections, such as Tuberculosis. Jim Drury went to meet him. Video provided by Reuters
Powered by NewsLook.com
Hugging It Out Could Help You Ward Off A Cold

Hugging It Out Could Help You Ward Off A Cold

Newsy (Dec. 21, 2014) Carnegie Mellon researchers found frequent hugs can help people avoid stress-related illnesses. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins