Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne
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The authors compared the length of labour periods, number of surgical deliveries, the use of oxytocin, analgetics, spasmolytics and intensity of pain in two groups of primiparae, who were in labor under continuous epidural analgesia (CEA). In the first group CEA was started when the cervix was dilated not more than 3 cm, in the second one when the cervix was dilated more than 3 cm. The length of labour, oxytocin consumption and frequency of vaginal surgery did not differ in the two groups. In the first group there was great consumption of analgetics and spasmolytics, more motor blocks of the lower extremities and a higher rate of Caesarean sections on account of dystocia. In some of the women of the first group the intensity of pain at the end of the first stage of labour and during the second stage was higher than before the onset of CEA. ⋯ It seems to be better to start CEA when the cervix is dilated more than 3 cm.
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From the anaesthesiological aspect the authors recommend the method of loss of resistance during verification of the epidural space as a safer method (lower percentage of perforations of the spinal dura mater). At the mentioned concentrations and dosage the authors did not observe any motor disorders of the lower extremities. ⋯ It puts, however, much greater demands on the staff and the costs are higher. These disadvantages should, however, not influence humanitarian trends in obstetrics.