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  • Title: Update on some aspects of the use of epidural analgesia in labour.
    Author: Okojie P, Cook P.
    Journal: Int J Clin Pract; 1999 Sep; 53(6):418-20. PubMed ID: 10622067.
    Abstract:
    The aim of the study was to investigate the effect of epidural analgesia on blood pressure, duration of the second stage and mode of delivery. In a prospective controlled study carried out in a district general hospital, 122 parturients made up the study population; 81 had epidural blocks and 41 had other forms of analgesia during labour. Data were collated using questionnaires within 48 hours of delivery: 58/81 (71.6%) of those who chose epidural were primigravidae compared with 14/41 (34%) in the non-epidural group (p < 0.001). During labour, minimum diastolic blood pressure was significantly lower in the epidural group: 65.8 versus 72.4 mmHg (p = 0.003). Mean duration of the second stage of labour was significantly longer in the epidural group: 108.3 versus 41.6 minutes (p < 0.0001); 28/81 (34.6%) of the epidural group had operative vaginal deliveries compared with 6/41 (14.6%) of the non-epidural group (p = 0.0004). Epidural analgesia provides an effective form of pain relief in labour, which has a particularly strong appeal to primigravidae. It has a hypotensive effect which can be put to beneficial effect in hypertensive disease of pregnancy, but is significantly associated with a lengthened second stage of labour, resulting in an increased operative vaginal delivery rate.
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