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1 - CONTINUOUS SPINAL ANALGESIA IN TRIAL FOR LABOUR USING WILEY SPINAL

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ESRA-2018

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Abstract

Continuous Spinal Analgesia in Trial for labour using Wiley Spinal O. Grimaud1 1Anesthetist, Clinique Saint Michel, Toulon, France Background and Aims: The aim of the study was to evaluate the advantages and drawbacks of CSA in trial for labour using Wiley Spinal over the needle catheter Methods: 51 ASA I and II parturients ( diabates , hypertension, tachyarrhythmia , previous C-Section ,and twin pregnancy ) , mean age of 28 years ( 20 to 40 ) were scheduled for labour trial . When regular contractions at a minimum 2 cm dilatation , a 23G catheter over a 27G pencil point spinal needle was introduced into the subarachnoid space through a peel-away canula , at the L2-L3 interspace , and a first bolus of 3 mg Ropivacaine with 2.5µg Sufentanil was injected intratechally Manual boluses of 3 mg Ropivacaine and 2µg sufentanil or 0.5 ml saline were administered on demand We focused on success rate onset of analgesia mean consumption of drugs side effects : hypotension motor block headache Results Onset of perfect analgesia:( VAS 0 in 80% of cases and 2 in 10patients ) : 5 to 10 min, at any dilatation Mean duration of labour was 6 hours with a mean consumption of 2,7 mg Ropivacaine and 1,8 µg Sufentanil hourly by spinal route Perfect hemodynamic stability without motor block 36 parturients ( 70%) delivered spontaneously ,10 cases ( 19,6%) had total comfort operative vaginal and 5 cases ( 9,8%) were successfully converted to Cesarean anesthesia . 2 parturients ( 3,9%), 40 and 38 years old had PDPH , requiring a blood patch Conclusions: CSA with Wiley Spinal is a satisfactory and safe technique for Labour

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