A Randomized Clinical Trial to Evaluate the Effect of Programmed Labour and Epidural Analgesia on Onset and Duration of Stages of Labour

Abstract

Background: The present study was conducted to evaluate the effect of programmed labour and epidural analgesia on onset and duration of stages of labour. Material and Methods: This randomized interventional clinical trial was conducted in department of Anaesthesia at Kamla Nehru State Hospital for Mother and Child, Indira Gandhi medical College Shimla in collaboration with Department of Anaesthesia on eighty uncomplicated pregnant women that were divided into two groups of 40 patients each by block randomization. One group received programmed labour protocol (Injection Pentazocine 6 mg + Injection Diazepam 2 mg IV + Injection Tramadol 1-1.5 mg/kg I.M therafter a single dose of injection Drotaverine 40 mg intravenously) while the other group received epidural analgesia. They were monitored for VAS score before and after intervention. Results: The two groups were comparable in terms of patients characteristics (age, parity, period of gestation). Both groups were comparable in terms of onset of labour Spontaneous labour seen in 65-70% of subjects. Regarding the duration of active phase of labour, In our study, In group 1 duration of active phase of 1 stage of labour was 215 min, and in group 2 it was 204 minutes with standard deviation of 32 minutes in group 1 and 40.4 minutes in group 2 respectively. Using student ‘t’ test this difference was found to be significant statistically. (P value less than 0.005). The mean duration of second stage of labour was 24.3 in group 1 and 35.8 min in group 2 with significant p valueless than 0.005. The mean duration of third stage of labour in our study was 5.89 minutes in group 1 and 5.7 min group 2. This difference is statistically insignificant (using student ‘t’ test (>0.005). Conclusion: Our study concluded that there was significant difference in first and second stage of labour in both groups while there was no significant difference in third stage and onset of labour in both groups.