Programmed Labour Analgesia and Epidural Labour Analgesia in Controlling Labour Pain

Abstract

Background: Labor analgesia has evolved from 18th century with the use of ether to present day practice of regional techniques. Labor analgesia has evolved from 18th century with the use of ether to present day practice of regional techniques. Variety of regional techniques, non-pharmacological methods and systemic analgesia had remodeled pain management in parturient resulting in better satisfaction. Objectives: To assess the Programmed Labour Analgesia and Epidural Labour Analgesia in Controlling Labour Pain. Methods: This randomized interventional clinical trial was conducted in the department of Anaesthesia at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh from January to June 2022. A total of 72 parturients in active labour were allocated into two equal groups by using random allocation software. Group (G1) was given epidural injection of 15 ml of ropivacaine 0.2% with 2mcg/ml fentanyl. Top up was given with same dose regimen in graded manner. Group (G2) was given programmed labour analgesia with Inj. Pentazocine 6mg IV+Inj. Diazepam 2mg IV+Inj. Tramadol 1mg/kg deep i.m and thereafter Inj. Drotaverine 40mg IV half hourly (maximum of 3 doses). Inj. Ketamine 0.25-0.5 mg/kg IV was given as resque analgesia. Quality of pain relief was assessed with VAS score. Results: Labour analgesia was better in epidural group (G1) with VAS decreased significantly at 5 min (p 3 and they required resque analgesia with ketamine. There were no significant changes in hemodynamics. Side effects were mild without needing any intervention. There was no effect on ambulation in group (G1). Local anaesthetics were needed for episiotomy in all cases in group (G2). No adverse effects were seen on neonate in either group. Conclusion: Epidural labour analgesia is a better option than programmed labour analgesia for pain relief in labour. In programmed labour satisfactory pain relief was not achieved and duration of analgesia was for shorter period. It does not affect ......