Programmed Intermittent Intrathecal Bolus for Maintenance of Labor Analgesia in an Obstetric Patient: A Case Report.

Journal

A&A practice

ISSN: 2575-3126

Titre abrégé: A A Pract

Pays: United States

ID NLM: 101714112

Informations de publication

Date de publication:
01 Dec 2023

Historique:

medline: 13 12 2023

pubmed: 13 12 2023

entrez: 13 12 2023

Statut: epublish

Résumé

Maintenance of labor analgesia with programmed intermittent epidural boluses (PIEBs) has demonstrated benefits over the use of continuous infusions. While programmed intermittent boluses have been used for the maintenance of epidural analgesia, it has not been reported for the maintenance of intrathecal analgesia. Approximately 25% of intrathecal catheters (ITC) ultimately fail, often due to inadequate analgesic coverage. We describe the use of programmed intermittent intrathecal boluses for a laboring parturient who received an ITC. She reported excellent pain relief without significant motor block, high anesthetic block, hypotension, or respiratory distress. This delivery modality may increase the rate of ITC after unintentional dural puncture (UDP).

Identifiants

DOI: 10.1213/XAA.0000000000001739 PMID: 38088757

pubmed: 38088757

doi: 10.1213/XAA.0000000000001739

pii: 02054229-202312000-00003

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

e01739

Informations de copyright

Déclaration de conflit d'intérêts

Conflicts of Interest: See Disclosures at the end of the article.

Références

Tien M, Peacher DF, Franz AM, Jia SY, Habib AS. Failure rate and complications associated with the use of spinal catheters for the management of inadvertent dural puncture in the parturient: a retrospective comparison with re-sited epidural catheters. Curr Med Res Opin. 2016;32:841–846.

Orbach-Zinger S, Jadon A, Lucas DN, et al. Intrathecal catheter use after accidental dural puncture in obstetric patients: literature review and clinical management recommendations. Anaesthesia. 2021;76:1111–1121.

Moaveni D. Management of intrathecal catheters in the obstetric patient. BJA Educ. 2020;20:216–219.

Tao W, Nguyen AP, Ogunnaike BO, Craig MG. Use of a 23-gauge continuous spinal catheter for labor analgesia: a case series. Int J Obstet Anesth. 2011;20:351–354.

Tao W, Grant EN, Craig MG, McIntire DD, Leveno KJ. Continuous spinal analgesia for labor and delivery: an observational study with a 23-gauge spinal catheter. Anesth Analg. 2015;121:1290–1294.

Palmer CM. Continuous spinal anesthesia and analgesia in obstetrics. Anesth Analg. 2010;111:1476–1479.

Carvalho B, George RB, Cobb B, McKenzie C, Riley ET. Implementation of programmed intermittent epidural bolus for the maintenance of labor analgesia. Anesth Analg. 2016;123:965–971.

Xu J, Zhou J, Xiao H, et al. A systematic review and meta-analysis comparing programmed intermittent bolus and continuous infusion as the background infusion for parturient-controlled epidural analgesia. Sci Rep. 2019;9:2583.

Klumpner TT, Lange EMS, Ahmed HS, Fitzgerald PC, Wong CA, Toledo P. An in vitro evaluation of the pressure generated during programmed intermittent epidural bolus injection at varying infusion delivery speeds. J Clin Anesth. 2016;34:632–637.

Heesen M, Hilber N, Rijs K, et al. Intrathecal catheterisation after observed accidental dural puncture in labouring women: update of a meta-analysis and a trial-sequential analysis. Int J Obstet Anesth. 2020;41:71–82.

Ayad S, Demian Y, Narouze SN, Tetzlaff JE. Subarachnoid catheter placement after wet tap for analgesia in labor: influence on the risk of headache in obstetric patients. Reg Anesth Pain Med. 2003;28:512–515.

Verstraete S, Walters MA, Devroe S, Roofthooft E, Van de Velde M. Lower incidence of post-dural puncture headache with spinal catheterization after accidental dural puncture in obstetric patients. Acta Anaesthesiol Scand. 2014;58:1233–1239.

Rana K, Jenkins S, Rana M. Insertion of an intrathecal catheter following a recognised accidental dural puncture reduces the need for an epidural blood patch in parturients: an Australian retrospective study. Int J Obstet Anesth. 2018;36:11–16.

Cohn J, Moaveni D, Sznol J, Ranasinghe J. Complications of 761 short-term intrathecal macrocatheters in obstetric patients: a retrospective review of cases over a 12-year period. Int J Obstet Anesth. 2016;25:30–36.