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ELECTRICAL IMPEDANCE TOMOGRAPHY EVALUATION OF THE EFFECTS OF EPIDURAL ANALGESIA ON SPONTANEOUS VENTILATION DURING LABOR
ESRA Academy. Doutreluigne M. Sep 8, 2016; 138571; 0445 Topic: Epidural Anaesthesia - Analgesia
Maxim Doutreluigne
Maxim Doutreluigne

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Abstract
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Background and Aims:

Measurement of atelectasis has been difficult until the electrical impedance tomography (EIT), which displays intrathoracic air location and movement as images and wave forms. This non-invasive, continuous bedside monitoring has been used in ICU settings, but never to monitor the effects of lumbar epidural analgesia on the redistribution of ventilation in pregnant women.

Methods:

Thirty healthy pregnant women in labor were included. Ventilatory measurements with the EIT monitor were done before and after lumbar epidural analgesia. Standard monitoring was applied. Pain was evaluated using the VAS scale. We compared global distribution of ventilation, and also regional differences in the lungs, by arbitrarily dividing the lungs in four regions of interest (ROI 1 to 4, from most anterior to most posterior)

Results:

The Bartlett’s Chi-square test of homogeneity of variances indicated that the variances were not different. The Tuckey’s rank-based multiple comparisons were applied to the data series. Results are expressed as median.
No differences were found in global ventilation of the lungs. Ventilation was better at the central lung regions, compared to the more peripheral lung regions, however no changes, neither in global, nor in regional atelectasis or ventilation were observed.

Conclusions:

This is the first EIT study evaluating the effects of epidural analgesia on atelectasis during labor. Although the gravid uterus should decrease functional residual capacity, the mechanism and distribution of mass are considerably different to those seen in other conditions, and therefore, favorable effects of epidural analgesia may not be applicable.

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