• E Canser, B Martínez, E Gredilla, F J Palacio, E Alonso, I Fornet, and F Gilsanz.
• Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Hospital Maternal, Madrid. enriquecanser@hotmail.com
• Rev Esp Anestesiol Reanim. 2006 Feb 1;53(2):82-7.

ObjectivesTo assess whether using a needle-locking device in combined spinal-epidural analgesia leads to better quality of pain relief for advanced stages of obstetric labor than can be achieved with conventional materials.Patients And MethodsA total of 230 women in advanced labor were randomized to 2 groups. In both groups the needle-through-needle technique was used. In group N we used a new technique with a Tuohy needle and a system for locking the spinal needle (27-gauge, pencil-point design). The conventional technique (group C) made use of the same Tuohy needle and spinal needle without the needle-locking device. The variables considered were patient characteristics, anesthesiologist, number of attempts and level of difficulty in carrying out the procedure, pain on a simple verbal visual analog scale before the procedure and 5 minutes later, latency, motor block, duration of spinal analgesia, complications, type of expulsion, and maternal satisfaction.ResultsThe 2 groups were similar with respect to all studied variables except duration of spinal analgesia (longer in group N, P<0.001); VAS after 5 minutes (lower in group N, P<0.010); latency (shorter in group N, P<0.001); lateralization (less in group N, P=0.034), and maternal satisfaction (greater in group N, P=0.037).ConclusionsThe use of devices specifically designed for administering combined spinal-epidural analgesia in advanced stages of labor provides faster pain relief, longer duration of analgesia, and greater maternal satisfaction without increasing the incidence of complications.

10 keywords...

hide…