Does Early Administration of Epidural Analgesia Affect Obstetric Outcome in Nulliparous Women Who Are Receiving Intravenous Oxytocin?

Lumbar Epidural Analgesia for Labor and Vaginal Delivery

“…The cesarean rate among women receiving epidural analgesia was 17% as compared with 4% among those who did not. The greatest increase in cesarean risk was noted when the epidural analgesic was administered early in labor, but there was more than a twofold increase regardless of dilation and station at administration of epidural analgesia [60], Another group of investigators randomized patients to receive epidural bupivacaine at 3 cm or greater cervical dilatation, but less than 5 cm, or intravenous nalbuphine followed by epidural bupivacaine only after the cervix was at least 5 cm dilated [58,59], In contrast to the studies discussed above, no difference in the incidence of malpo sition, instrumental delivery, or cesarean section ap peared between the groups. The same results occurred in a group of nulliparas receiving oxytocin [58] and in a sec ond group who were in spontaneous labor [59].…”

Haemodynamic consequences and uterine contractions following 0.5 or 1.0 litre crystalloid infusion before obstetric epidural analgesia

“…Similarly, Abboud et al 7 failed to identify any change in uterine activity after epidural injection of bupivicaine, chloroprocaine or lidocaine. Chestnut et al 8,.9 have recently demonstrated that early administration of epidural analgesia did not prolong labour in nulliparous women compared with women receiving nalbuphine analgesia iv.…”

Aktuelle Versorgungskonzepte in der geburtshilflichen Anästhesie

“…Metaanalysen randomisiert-kontrollierter Studien zeigen unklare Ergebnisse für spontane, instrumentelle Entbindungen und Sectiones beim Vergleich von früh-zeitiger (Muttermund < 4-5 cm) und später (Muttermund > 4-5 cm) Anlage einer PDA [36][37][38][39][40]. Auch eine Studie, die sich mit dem Vergleich von früher und spä- [85][86][87][88][89][90].…”