Döndü MORALAR GENÇ, Ülkü TÜRKMEN AYGEN, HATİCE AYSEL ALTAN, Resul ARISOY, Emre TAHAOĞLU, Ekrem ÖZAKIN

Doğum analjezisinde epidural sürekli infüzyon ve hasta kontrollü epidural bolus uygulamasının karşılaştırılması

Amaç: Çalışmamızda vaginal doğumda epidural katater takılarak düşük doz levobupivakain ve fentanil kombinasyonu ile yapılan sürekli infüzyon ve hasta kontrollü bolus uygulamanın anne, bebek ve doğum süreci üzerine etkisini karşılaştırmayı amaçladık. Gereç ve Yöntem: Çalışmaya katılan 45 gebe rastgele Grup HKEB (hasta kontrollü epidural bolus) ve Grup SEİ (sürekli epidural infüzyon) olarak iki gruba ayrıldı. Gebelerin hemodinamik parametreleri ve VAS değerleri, fetal kalp tepe atımı, be- bek APGAR skorları, doğum evrelerinin süreleri, doğum şekilleri ve yan etkiler kaydedildi. T10 dermatoma ulaşma süreleri belirlendi. Motor blokaj düzeyleri modifiye Bromage skalası ile değerlendirildi. Ek analjezik ihtiyaçları takip edildi, toplam ilaç tüketimleri karşılaştırıldı. Bulgular: Hasta kontrollü epidural bolus uygulamada toplam ilaç tüketiminin anlamlı olarak daha az olduğunu görüldü (p

The comparison of epidural continuous infusion and epidural patient controlled bolus administration in labor analgesia

Objectives: We aimed to compare the efficacies of patient controlled bolus administration and continuous infusion of low dose Fen- tanyl and Levobupivacaine combination by epidural catheter during vaginal labor on mother, baby and the duration of labor. Methods: The 45 pregnant women involved in the study were divided randomly into two groups, Group HKEB (patient controlled epidural bolus) and Group SEI (continuous epidural infusion). Hemodynamic parameters and VAS values of the pregnant women, fetal heart rate, Apgar scores, duration of labor stages, types of delivery and side effects were recorded. Time to reach the T10 dermatome was determined. Motor block was evaluated with modified Bromage scale. Additional analgesic needs were followed up and total drug consumptions were compared. Results: Drug consumption was found to be significantly lower in HKEB administration (p<0.01). Conclusion: Bolus administration of a basal dose that will keep the analgesia level constant and additional drugs administered upon patient requests will prevent pregnant women from experiencing a painful period, and will provide confidence and comfort to patients who need to ask for drugs according to their pain characteristics

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