The effect of epidural and opiate analgesia in mid trimester induced abortions was investigated by the authors in a prospective randomised control trial. The number of patients was 51. Twenty five of them had epidural analgesia. They were given either 0.375% or 0.25% bupivacaine according to the randomised protocol. Control groups included those patients who refused epidural analgesia. Patients in the first control group did not ask for any type of analgesia whereas the second control group received pethidine-intramuscularly. To characterise the speed of abortion the authors proposed to establish the definition of CERVIX-VALUE (CV) calculated mathematically from the cervix-index (CI) in which the first number was considered after modification N(CV1) = 3-N(CI1 (e.g. if CI = 2111, CV = (3-2)+1+1+1=4). For abortion induction intracervical laminaria introduction, extraamnial ethacridine administration, followed by i.v. oxytocin infusion were carried out. There was a significant lengthening of the abortion time measured in hours in case of the 0.25% Bupivacaine EDA group when compared to the first control group i.e. the group with no analgesia at all (P<0.05) as well as there was a significant increase in the time period measured in days when compared to the group with no analgesia whatsoever (P<0.05). Compared 0.375% Bupivacaine EDA group to control groups there was no significant increase of the abortion time measured in hours or days. This effect could be attributable to the increased sympatholytic activity of high concentration Bupivacaine leading to a pronounced smooth muscle relaxation in the cervix. A significantly greater amount of oxytocin was required for the induced abortion in the 0.25% Bupivacaine, group (P<0.05). The cervical-change speed calculated on the basis of the CERVIX-VALUE by the authors did not show significant alterations.
|Number of pages||7|
|Journal||Magyar Noorvosok Lapja|
|Publication status||Published - Jun 30 1995|
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology