Abstract | AIM: MATERIAL AND METHODS: A total of 1401 nulliparous women with a singleton pregnancy who received fentanyl i.v.-PCA (i.v.-PCA group, n = 290) or no analgesia (control group, n = 1111) in labor between 2005 and 2010 were reviewed. Fentanyl i.v.-PCA was implemented on maternal request during the first stage of labor over 35 weeks of gestation, and discontinued at full cervical dilatation. Perinatal outcomes were compared between the i.v.-PCA and the control groups. The numerical rating scale (NRS) levels during labor were also examined in the i.v.-PCA group. Additionally, parturients received fentanyl i.v.-PCA in 2010 (n = 73) were asked about overall satisfaction using a scale poor, moderate, good and excellent on postpartum day 0-3. RESULTS: Women receiving i.v.-PCA showed significantly longer labor and more need of oxytocin augmentation, compared with the control. Cesarean section was significantly less frequent in the i.v.-PCA group compared with the control (11.0% v.s. 24.1%, respectively), with the vacuum-assisted delivery rate comparable between groups. Neonatal outcomes (i.e. Apgar score <7 at 1 min or 5 min, umbilical artery pH <7.20) were comparable between groups, irrespective of mode of delivery. Significant reduction of NRS levels was noted until 3 h after induction of i.v.-PCA, compared to the baseline. Of the women who expressed their satisfaction, 72% (48/67) exhibited 'excellent' or 'good' for pain relief by i.v.-PCA. CONCLUSION:
Fentanyl i.v.-PCA could be a useful approach for labor pain relief in nulliparas when regional blocks are unavailable.
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Authors | Kei Miyakoshi, Mamoru Tanaka, Hiroshi Morisaki, Seon-Hye Kim, Yuki Hosokawa, Tadashi Matsumoto, Kazuhiro Minegishi, Yasunori Yoshimura |
Journal | The journal of obstetrics and gynaecology research
(J Obstet Gynaecol Res)
Vol. 39
Issue 4
Pg. 783-9
(Apr 2013)
ISSN: 1447-0756 [Electronic] Australia |
PMID | 23167696
(Publication Type: Comparative Study, Journal Article)
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Copyright | © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology. |
Chemical References |
- Anesthetics, Intravenous
- Fentanyl
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Topics |
- Adult
- Analgesia, Patient-Controlled
(adverse effects)
- Anesthesia, Obstetrical
(adverse effects)
- Anesthetics, Intravenous
(administration & dosage, adverse effects)
- Cohort Studies
- Female
- Fentanyl
(administration & dosage, adverse effects)
- Humans
- Japan
- Patient Satisfaction
- Pregnancy
- Retrospective Studies
- Term Birth
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