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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
EBERLE, Andrea Stolf et al. The interaction between labor analgesia and its results: assessment using the newborn´s weight and Apgar score. Rev. Bras. Anestesiol. [online]. 2006, vol.56, n.4, pp. 343-351. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942006000400002.
BACKGROUND AND OBJECTIVES: There are controversies regarding whether labor analgesia can interfere with labor and the vitality of the newborn. The objective of this study was the interaction between labor analgesia, using the continuous epidural and combined spinal-epidural techniques with a small dose of local anesthetic, and the type of delivery analyzing the newborn's weight and Apgar score. METHODS: The results of 168 labor analgesias (from January 2002 to January 2003) were analyzed. They were divided in 4 groups: G1 (n = 58), continuous epidural and evolution to vaginal delivery; G2 (n = 69), combined spinal-epidural and evolution to vaginal delivery; G3 (n = 25), continuous epidural and evolution to cesarean; G4 (n = 16), combined spinal-epidural and evolution to cesarean. G1 received 0.125% ropivacaine (12 to 15 mL), G2 received subarachnoid 0.5% bupivacaine (0.5 to 1 mL) and sufentanil (10 mg). Epidural ropivacaine 0.5% for the vaginal delivery (8 mL) and for cesarean (20 mL). The patient's age, weight, height, body mass index (BMI), gestational age, number of prior pregnancies, and complications (arterial hypotension, bradycardia, and hypoxia) and the newborn's weight and Apgar score (at 1, 5, and 10 minutes) were evaluated. RESULTS: The majority of pregnant women were primiparous and presented with a term pregnancy (one with gestational age of 28 weeks and none post-term pregnancy); weight, G2 < G4; and MBI, G2 £ G4. For the weight of the newborn, G1 < G3 and G2 < G4, and for the Apgar score at 1st minute, G1 > G3. CONCLUSIONS: If the analysis focuses the newborn's weight and Apgar score, the techniques of analgesia, continuous epidural and combined spinal-epidural with small doses of local anesthetic, do not interfere with the result of the delivery.
Keywords : ANALGESIA, Labor; ANESTHETICS, Local; SURGERY, Obstetric [cesarean section].