Low-dose spinal anaesthesia provides effective labour analgesia and does not limit ambulation
Bibliographic record
Abstract
Background: While epidural analgesia for labour pain is standard in high-resource countries, minimal to no analgesia is usually provided in low-resource countries. Intrathecal local anaesthetics provide good pain relief, but the potential impact on ambulation is of concern. Our objective was to determine if a low-dose local anaesthetic combined with an opioid would provide reasonable pain relief, while allowing ambulation in a low-resource setting.Method: This prospective, observational study was conducted at the Tamale Teaching Hospital in Tamale, Ghana. Spinal analgesia was administered to healthy women in labour using a pencil-point 25-G spinal needle at the L3–L4 or L4–L5 interspace, with patients in the sitting position. The intrathecal mixture contained 25 μg of fentanyl, 2.5 mg of bupivacaine and 0.2 mg of morphine. The patient’s ability to ambulate following the administration of a low-dose spinal injection was the primary outcome measured. Pain ratings, blood pressure, nausea, vomiting, pruritus, headaches and foetal bradycardia were also recorded.Results: Three hundred and thirty-two parturients consented to participate. Following spinal injection, 328 women (98.8%) experienced mild to no pain, and 4 (1.2%) moderate pain. The administration of spinal analgesia had no effect on ambulation in 291 (87.7%) patients, and a mild effect in 41 (12.3%) patients. Intrathecal analgesia did not severely limit ambulation in any of the patients.Conclusion: Low-dose intrathecal analgesia can provide effective analgesia for labouring patients in low-resource settings without limiting ambulation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".