The Effect of Abdominal Massage on the Onset of Epidural Blockade in Laboring Women

Abstract

To the Editor: Ueda et al. [1] demonstrated that light abdominal massage can hasten the regression of epidural blockade after elective laparoscopy. We performed a pilot study to discover whether it might also speed the onset of epidural blockade. We studied 15 women in labor requesting epidural analgesia. An epidural catheter was inserted and 0.125% bupivacaine in a 5-mL test dose given plus 15 mL 5 min later. Nine women received gentle massage of the periumbilical area by the partner for 15 min starting with the test dose, and six women received no massage. The pain of contractions was assessed using a 100-mm visual analog scale over the next 30 min. The times to contractions becoming bearable, to contractions becoming painless, and for the sensation of contractions to return were also recorded. There was no significant difference between the groups in these times Table 1 or in the visual analog scale scores.Table 1: Comparison Between Groups of Mean (SD) Times for Onset and Offset of AnalgesiaThe number of patients studied is small, but comparable with the number in the study by Ueda et al. [1], in which they found a significant difference in epidural offset time in the two groups. We conclude that abdominal massage does not produce a clinically useful alteration in time of onset of epidural analgesia for labor. Timothy J. Parke, MD S. Michael Kinsella, MD Sir Humphry Davy Department of Anaesthetics St. Michael's Hospital Bristol BS2 8EG, United Kingdom