Espinoza-Espinosa JJ, Michel-Macías R, Lozada-Villalón N

Language: Spanish
References: 13
Page: 158-164
PDF size: 501.60 Kb.

ABSTRACT

Background: Obstetric pain is defined as the symptom or unpleasant sensation caused by the contraction of the uterine muscle and the movement of the fetus through the birth canal; this being the most frequent cause of pain in pregnant women. Knowledge of the mechanisms that produce obstetric pain is also important, this will allow us to perform the analgesia, as selective as possible, according to the evolution of labor. Continuous lumbar epidural anesthesia is the most efficient, controllable and safe technique for obstetric analgesia.
Material and methods: Longitudinal Study, Prospective, Simple Blinded, Randomized and Comparative Clinical Trial, analyzed through measures of central tendency, T-test for numerical variables, Fisher for frequency variables and Chi Square for sampling. The objective was to evaluate the effectiveness of Nalbuphine epidural analgesia in obstetric patients in labor compared with conventional analgesia with fentanyl.
Results: Both groups showed pre-administration EVA mean 8/10, with a mean progressive reduction of 2 points every 15 minutes after drug administration as well as the decrease of 10% in BP and FC after 30 minutes. Mean Richmond Score of 1 after 30 minutes.
Conclusions: It was observed that there was no statistical significance in improving labor and labor pain using Nalbuphine compared with Fentanyl. It is significantly cheaper and easier to purchase Nalbuphine than fentanyl. Because both drugs have similar capacity for pain management it is concluded that it is a good and viable choice. Neonatal depression was not observed during the use of these drugs.

REFERENCES

1. Melzack R. The McGill Pain Questionaire: Major properties and scoring methods. Pain 1975;1:277-79.

2. Collins j . Anestesiología Ed McGranw-Hill 3era edicion 1993.

3. Morgan Anesthesiology 4th Edition 375-410.

4. Manual De Anestesia Clinica 4th Edicion Barash Mc Graw Hill Education 2003 200-290.

5. Anestesia 5th Edicion Massachusetts Editorial Marban 2005 415-530.

6. Ronald D. Miller E-dition elsevier science health science 2007 650-710.

7. Farmacología Para Anestesiólogos J.A. ALDRETE; M.A. PALADINO, CORPUS, 2008 150-250.

8. Morin R. Pedro “ Analgesia Epidural Continua para el trabajo de parto” Revista Mexicana de Anestesiologia 3 22-27. 1998.

9. Price C., Lafraneire, Bossnan C. “ Regional analgesia in carny labour: combinerd spinal epidural vs epiduralk anesthesia 53. 951-955. 1998.

10. Revista Mexicana De Anestesiología “ nalbufina peridural en dolor postoperatorio” Dra. María Del Socorro Espíritu-Muñoz, Delwyn Cordero-Luna, Miguel Ángel Gonzalez-Velazquez 1995; 18:4 204-207.

11. Anales Médicos Evaluación De Analgesia Obstétrica Con Nalbufina Peridural Sp Administrada Por Via Peridural Volumen 49, Numero 1,Enero–Marzo 2004.

12. Revista Mexicana de Anestesiologia. Dr. Jose Ricardo Zela Huachisco, Hector Ramirez Jasso. “Estudio comparativo de Nubain sin parabenos contra lidocaína al 1% con epinefrina para analgesia obstétrica”. Volumen 1, no. 1 Enero-Marzo 2001.

13. Prospective national survey on alternatives to obstetrical peridural analgesia Nalbuphine in obstetrical analgesia.