Pregnant women undergoing a normal course of labor may be able to safely consume food or drink while receiving epidural anesthesia, thereby increasing their perception of satisfaction. Researchers at Magee-Womens Hospital of the University of Pittsburgh Medical Center, in Pittsburgh, found that laboring women who drank a high-protein shake reported more satisfaction than those who were allowed only ice chips, with no increase in complications. The study results were presented at the 2011 annual meeting of the Society for Obstetric Anesthesia and Perinatology (abstract 25).
A strict policy of nothing by mouth (NPO) is imposed during labor to reduce maternal morbidity and mortality, said senior author Manuel C. Vallejo, MD, professor and director of obstetric anesthesia at the Pittsburgh hospital. But the widespread use of regional anesthesia and improved general anesthetic techniques have significantly decreased the incidence of maternal aspiration, he said. Facilities in Northern Europe, including Switzerland, have adopted a less restrictive NPO policy.
All patients received patient-controlled epidural anesthesia of 0.08% bupivacaine with 2 mcg/mL of fentanyl. The researchers monitored the patients for episodes of nausea and vomiting at hourly intervals until delivery. After delivery, participants were asked to rate their overall satisfaction.
Overall, 21.4% of women in the protein-shake group had nausea, compared with 33.3% in the ice-chips group (P=0.43). In the protein-shake group, 10.7% of the women experienced vomiting, compared with 12.8% of the ice-chips group (P=0.91). Average satisfaction scores were 92 out of 100 in the protein-shake group and 90 out of 100 in the ice-chips group (P=0.05). Aspiration did not occur in any of the patients, and none required a general anesthetic. Two women in the protein-shake group and five women in the ice-chips group had a cesarean delivery.
Dr. Vallejo told Anesthesiology News that as long as women have a functioning epidural and normal progression of labor, “it’s probably OK to have something to eat or drink. It’s good for the women’s well-being, and it increases patient satisfaction.” He said the study is ongoing, and now includes about 107 women. Some patients who heard about the study have asked to participate, he said.