The effects of epidural analgesia in normal labor

Abstract

Introduction: Labor pain is the most severe pain a women would experience and several treatment modalities have been adopted since decades. Labor analgesia using epidural technique is considered as the efficient and effective treatment options available. Parturients in India especially rural areas are less aware regarding labor analgesia using epidural technique. Aim: To study the effects of labor analgesia using epidural technique in nulliparous women. Materials and Methods: Sixty full term nulliparous women with singleton vertex pregnancy were made aware of labor analgesia using epidural technique and included, those willing were grouped epidural(n=30), those not keen were grouped control(n=30). In 1st stage labor, parturients in epidural group received bupivacaine and fentanyl, whereas in control group received intramuscular Inj. tramadol, and Inj. pethidine if needed. Duration of 1st and 2nd stage labor, pain relief, maternal satisfaction, adverse effects, instrumental deliveries, 1st and 5th minute Apgar score and NICU admission were recorded. Results: The mean duration of first stage labor was shorter (p=0.071) in epidural group (250.17±106.33 minutes) compared with control group (302.0±111.99 minutes) and statistically insignificant prolongation (p=0.892) (18.73±6.82 minutes) of 2nd stage labor as compared to control (18.33±14.53 minutes). Pain relief in epidural group was statistically significant (pst (p=0.306) and 5th minutes (p=1.00), NICU admission rate were statistically insignificant (p=0.143) between groups. Conclusion: Labor epidural analgesia using Inj.bupivacaine and Inj.fentanyl provides good pain relief, safe for mother and baby. It does not affect labor duration, instrumental delivery rate or neonatal outcome. Keywords: Labor analgesia, Epidural, Bupivacaine, Fentanyl, Labor stages, Apgar score, NICU admission.