Author | dc.contributor.author | Contreras, Felipe | |
Author | dc.contributor.author | Morales, Juan | |
Author | dc.contributor.author | Prieto Bravo, Daniela | |
Author | dc.contributor.author | Layera, Sebastián | |
Author | dc.contributor.author | Jara, Álvaro | |
Author | dc.contributor.author | Riaño, Carlos | |
Author | dc.contributor.author | Pizarro, Rodrigo | |
Author | dc.contributor.author | Fuente, Natalia de la | |
Author | dc.contributor.author | Aliste, Julián | |
Author | dc.contributor.author | Finlayson, Roderick J. | |
Author | dc.contributor.author | Tran, D. Q. | |
Admission date | dc.date.accessioned | 2019-10-30T15:32:34Z | |
Available date | dc.date.available | 2019-10-30T15:32:34Z | |
Publication date | dc.date.issued | 2019 | |
Cita de ítem | dc.identifier.citation | Regional Anesthesia and Pain Medicine, Volumen 44, Issue 7, 2019, Pages 750-753 | |
Identifier | dc.identifier.issn | 15328651 | |
Identifier | dc.identifier.issn | 10987339 | |
Identifier | dc.identifier.other | 10.1136/rapm-2019-100608 | |
Identifier | dc.identifier.uri | https://repositorio.uchile.cl/handle/2250/172484 | |
Abstract | dc.description.abstract | This double-blind, randomized trial compared dural puncture epidural analgesia (DPEA) for labor using 25-gauge and 27-gauge pencil point spinal needles. We hypothesized that both needle sizes would result in similar onset time (equivalence margin=2.5 min) and therefore designed the study as an equivalence trial. Methods One hundred and forty patients undergoing labor were randomized to DPEA with 25-gauge (n=70) or 27-gauge (n=70) pencil point spinal needles. After the placement of the epidural catheter, a bolus of 20 mL of bupivacaine 0.125% and fentanyl 2 μg/mL was administered to all subjects. Thereafter, patients received boluses of 12 mL of bupivacaine 0.125% every 2 hours as needed. A blinded investigator recorded the onset time (defined as the temporal interval required to achieve a pain score ≤1 on a 0-10 scale), S2 block, sensory block height (30 min after the initial bolus of local anesthetic), presence of motor block (30 min after the initial bolus of local anesthetic), number of top-up doses required during labor and incidence of postural headache. Results Out of the 140 recruited patients, 135 were retained for analysis. Compared with their 27-gauge counterparts, 25-gauge pencil point spinal needles provided a 1.6 min shorter DPEA onset (95% CI of the difference of the means:-3.2 to-0.1 min). However, there were no intergroup differences in terms of S2 block, sensory block height, motor block, number of top-up doses and incidence of postural headache. Conclusion Dural puncture epidural analgesia with 25-gauge pencil point spinal needles provides a 1.6 min shorter onset time than DPEA with 27-gauge spinal needles. Although statistically significant, such a difference may not be clinically relevant. Further investigation is required to compare 25-gauge and 27-gauge spinal needles for DPEA in the setting of different local anesthetic infusion strategies. Trial registration number NCT03389945. | |
Lenguage | dc.language.iso | en | |
Publisher | dc.publisher | BMJ Publishing Group | |
Type of license | dc.rights | Attribution-NonCommercial-NoDerivs 3.0 Chile | |
Source | dc.source | Regional Anesthesia and Pain Medicine | |
Keywords | dc.subject | Neuraxial blocks: continuous techniques | |
Keywords | dc.subject | Neuraxial blocks: epidural | |
Keywords | dc.subject | Postdural puncture headache | |
Keywords | dc.subject | Spinal/epidural injection | |
Título | dc.title | Dural puncture epidural analgesia for labor: A randomized comparison between 25-gauge and 27-gauge pencil point spinal needles | |
Document type | dc.type | Artículo de revista | |
dcterms.accessRights | dcterms.accessRights | Acceso a solo metadatos | |
Cataloguer | uchile.catalogador | laj | |
Indexation | uchile.index | Artículo de publicación SCOPUS | |
uchile.cosecha | uchile.cosecha | SI | |