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Study aim
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Comparison of the Maternal Hemodynamic between Epidural Analgesia Delivery and Combined Spinal-Epidural Analgesia Delivery
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Design
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One hundred healthy mother with term and singleton pregnancy candidate for NVD with neuroaxial analgesia, entered the study after obtaining written informed consent, will be placed respectively and randomly into two groups of 50 (combined or epidural).
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Settings and conduct
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Pregnant women in Taleghani hospital in Tabriz, are randomly and blinded assigned into two groups (epidural or combined).
Tow technicians who are blind to the analgesia record the maternal V/S and occurence of hypotension.
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Participants/Inclusion and exclusion criteria
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Entrance criteria: Ability to have a normal vaginal delivery
The delivery to be in the active phase.
Exit criteria:
Dissatisfaction, Inability of the pregnant to remain motionless while doing work, Coagulation disorder, Increased intracranial pressure, Local infections. History of sensitivity, Acute lesions of the CNS, Hemodynamic Disorders, Cardiovascular Diseases, Embryonic distress, GA <37 w, Abnormal fetal presentations, History of C/S - BMI> 40
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Intervention groups
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First 500cc of Ringer Lactate fluid will be prescribed. The neuroaxial blocks will be performed from the intervertebral space L3-4 or L4-5 with a (lack of resistance) technique. In the epidural group, the block with epidural needle number 18 G is performed. First, for the test dose: 3 ml of lidocaine 1.5%, 50 μg of fentanyl and 2.5 mg of bupivacaine is used. Then as a preservative dose 6 cc / h from the solution is injected through the catheter. In the combination group, first with spinal needle 25G, the spinal block with 1.5ml of the same solution is performed and then the epidural block will be performed using the same method of epidural group.
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Main outcome variables
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Reducing labor pain and C/S; Choosing an analgesic with the least complication