Intradermal Sterile Water Injection versus Epidural Bupivacaine in Painless First Stage of Labor

Abstract

Background: Many women have moderate to severe low back pain during labor. It has been shown that injection of sterile water can reduce the pain of 1ststage. This method is very cheap, easy to learn and can be used as alternative method for reducing the labor pain. Objectives: The aim of this study was to compare the effectiveness, women satisfaction safety and safety of intradermal sterile water injection and epidural bupivacaine in decreasing the pain of1st stage of labor. Patients and Methods: After approval of Institutional Ethical Committee and obtaining written informed consent from eligible parturient women, 120 healthy parturient divided into 3 groups. 1st group epidural bupivacaine plus fentanyl, Initiated with 10 ml of bupivacaine 0.125% with 2 micrograms/ ml of fentanyl and maintained with 10 ml/ h of the same mixture. 2nd group intradermal injection of sterile water 0.1 ml, while 3rd group intradermal injection of 0.1 ml normal saline. Results: The study reported good pain relief in epidural and sterile water group compared to normal saline group. Pain relief was comparable in both the epidural and sterile water group. Complications were more demonstrated in epidural compared to the sterile water and the normal saline groups. A good maternal satisfaction in epidural and sterile water group with no satisfaction in the normal saline group. Conclusion: The evidence from this study suggests that sterile water injections are safe and effective method for relieving pain of the 1st stage of labor similar to epidural bupivacaine analgesia.