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If the analgesia was insufficient one or two single injections of 5 ml of bupivacaine were added. Statistical evaluation of the results could be carried out for 218 women, 158 of whom were nulliparae and 60 multiparae. Fully satisfactory analgesia was achieved in 96 per cent of the nulliparae and 88 per cent of the multiparae in the first stage of labor. in the second stage of labor 46 per cent of the mothers were given pudendal blockade to maintain satisfactory analgesia.<\/jats:p><jats:p>The positioning of the patient in the first stage of labor from supine to semirecumbent was of importance to spread the analgesic agent caudally, to the sacral nerve roots, and to control the pain due to stretching of the vagina and perineum. in the total material 17 per cent of the neonates were delivered by vacuum extraction. When the infusion into the epidural space was started in early labor, the incidence of vacuum extraction was 9 per cent, as compared with 38 per cent when it was started at 6 cm cervical dilatation or later (<jats:italic>p<\/jats:italic>:&lt;0.01). 9.8 per cent of the neonates were delivered by cesarean section. Fetal head malposition occurred in 8.7 per cent. a drop in blood pressure was noted in 7 per cent of the women. the condition of the newborn was unaffected by the analgesia. the mini\u2010infusion system minimized the risk for infection. the danger in case of accidental intravascular injection was reduced, due to slowly administered bupivacaine. At the maternity department this technique has created a positive attitude towards epidural blockade, as mid\u2010wives and doctors have found it safe and easy.<\/jats:p>","DOI":"10.3109\/00016347909157222","type":"journal-article","created":{"date-parts":[[2009,12,8]],"date-time":"2009-12-08T18:03:57Z","timestamp":1260295437000},"page":"43-52","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["CONTINUOUS MINI\u2010INFUSION OF BUPIVACAINE INTO THE EPIDURAL SPACE DURING LABOR"],"prefix":"10.1111","volume":"58","author":[{"given":"A.","family":"Matouskova","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Hanson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Elm\u00e9n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,1,11]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-195301000-00013"},{"key":"e_1_2_1_3_1","first-page":"289","article-title":"Clinical EEG correlations in vacuum\u2010extracted children","volume":"25","author":"Arseni C.","year":"1968","journal-title":"Electroencephalogr Clin Neurophysiol"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/45.10.1067"},{"key":"e_1_2_1_5_1","unstructured":"Berlin\u2010Wahl\u00e9nA..Studies on the elimination of local anesthetic agents.Thesis Universitatis Upsaliensis.1977."},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-195709000-00008"},{"key":"e_1_2_1_7_1","first-page":"48","volume-title":"Psychosomatic aspects of labour and anaesthesia. 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