Effects of Epidural Analgesia on Labor Pain and Course of Labor in Primigravid Parturients: A Prospective Non-randomized Comparative Study

Deepak, Dipika; Kumari, Archana; Mohanty, Rajat; Prakash, Jay; Kumar, T Senthil; Priye, Shio

doi:10.7759/cureus.26090

Cited by 6 publications

(7 citation statements)

References 25 publications

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“…Since the hypothalamus is the thermoregulation center, the combination of the 2 factors might cause an increase in the body temperature of the parturient. [ 31 ] Nalbuphine partially antagonizes opioid receptors, which, in this study, might explain the lower percentage of epidural-related maternal fever occurring in the nalbuphine group, in comparison with the control group. Epidural labor analgesia is known to be effective in relieving pains related to contraction and labor.…”

Section: Discussionmentioning

confidence: 60%

Efficacy and safety of nalbuphine for epidural labor analgesia at high altitude: An observational study

Wang,

Yu,

Cheng

et al. 2024

Medicine

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Xining is located at the eastern edge of the Qinghai-Tibet Plateau, with an average altitude of >7000 feet (>2000 m). Nalbuphine is a kappa-opioid receptor agonist that can provide analgesia with fewer side effects than other opioid analgesics. This study aimed to evaluate pain control, side effects, and neonatal outcomes from combining nalbuphine with sufentanil and ropivacaine in 600 women during epidural anesthesia while giving birth at a high altitude in Xining, China. A total of 600 parturients receiving epidural labor analgesia were randomly divided into 2 groups, each group 300 parturients. The nalbuphine group received nalbuphine, sufentanil, and ropivacain, the control group only received sufentanil and ropivacain. The analgesic effect was evaluated through the Visual Analogue Scale scores. Neonatal outcomes were mainly evaluated through the Apgar Scores. Compared to the control group, the nalbuphine group showed lower Visual Analogue Scale scores at all time points after analgesia (P < .05). In comparison with the control group, parturients in the nalbuphine group showed lower incidence rates of fever at delivery, 24-hour postpartum bleeding, and pruritus (P < .05). However, between the 2 groups, there were no statistically significant differences in the remaining maternal and infant outcomes and neonatal outcomes (P > .05). Moreover, no adverse effects on neonatal outcomes were observed. The findings from this study support findings from previous studies that nalbuphine provided safe epidural analgesia without significant side effects for the mother and infant, and showed both safety and efficacy when used during labor at high altitude.

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Section: Discussionmentioning

confidence: 60%

Efficacy and safety of nalbuphine for epidural labor analgesia at high altitude: An observational study

Wang,

Yu,

Cheng

et al. 2024

Medicine

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“…In the study of Deepak et al 1 minute APGAR score was found to be lower in the study group but the APGAR at 5 minute in the two groups did not show any significant difference. 20 Cochrane review by Anim-Somuah et al also found no differences between groups in neonatal outcomes in terms of Apgar score at 5 minute. 17 Naito et al also observed the outcomes of the neonates and found there were no clinical differences between the two groups.…”

Section: Discussionmentioning

confidence: 95%

Evaluation of the effects of epidural labour analgesia on mode of delivery

Khatun,

Rahim,

Rahman

2024

Int J Reprod Contracept Obstet Gynecol

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Background: Epidural analgesia is the most effective method of pain relief during labour and the only method that provides complete analgesia without maternal or foetal adverse effects. This study aimed to assess the mode of delivery outcomes of labour in women who had received effective epidural analgesia. Methods: After ethical approval, this quasi-experimental study was carried out in Dhaka medical college hospital for one year, from July 2021 to June 2022. A total of 100 admitted pregnant women (37 weeks to 41 weeks) in the labour ward were included in the study according to the inclusion and exclusion criteria. Among them, 50 women were in group A (with epidural analgesia), and the other 50 were in group B (without epidural analgesia). A detailed history and thorough clinical examination were carried out on each patient. Data were collected in separate case-record forms and analyzed using SPSS 24. Results: Mean age, gestational age, parity, and body mass index were statistically similar in both group A and B. Normal vaginal delivery rate (86% vs. 90%), instrumental delivery rate (10% vs. 6%), and caesarean section rate (4% vs. 4%) were not significantly different in both groups. Besides, both group A and B had statistically similar APGAR scores at 1st (8.66±0.87 and 8.80±0.83 respectively, p=0.414) and 5th min (9.66±0.68 and 9.74±0.59 respectively, p=0.537). Conclusions: Epidural labour analgesia can be safely recommended as a method of labour analgesia, provided the prerequisites are fulfilled. It has no significant adverse effect on the mode of delivery.

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“…Wong CA et al also reported that NA in early labor (when the cervix is less than 4.0 cm dilated) did not increase the rate of CD [ 21 ]. Deepak D et al also found that NA did not increase the risk of CD and instrumental vaginal birth [ 22 ]. Our study similarly revealed no significant differences in the rates of intrapartum CD, forceps-assisted vaginal delivery, episiotomy and natural vaginal delivery among multiparous women in the no-NA, early-NA and late-NA groups.…”

Section: Discussionmentioning

confidence: 99%

Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

Cheng,

Xiong,

et al. 2024

BMC Anesthesiol

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Background The mechanism underlying maternal fever and prolonged labor progression associated with neuraxial analgesia (NA) remains elusive, raising concerns among certain pregnant women regarding the application of NA during vaginal delivery. This study aimed to investigate the impact of early and late NA on maternal and neonatal outcomes in multiparous women. Methods This retrospective study collected data from 1119 multiparous women with singleton pregnancies, full term and live births at our labor and delivery center between August 1st, 2021 and July 31st, 2022. Based on the timing of NA initiation, participants were categorized into three groups: no-NA, early-NA and late-NA. The no-NA group comprised of 172 women who did not receive NA during vaginal delivery; the early-NA group included 603 women in which NA was initiated when cervical dilation was between 0.5 and 2.0 cm; and the late-NA group comprising 344 cases in which NA was initiated at the cervical dilation of ≥ 2 cm. Maternal and neonatal outcomes were observed, including durations of the first, second, third and total stage of labor, the rate of intrapartum cesarean delivery (CD), intrapartum fever, postpartum hemorrhage (PPH), transfer to intensive care unit (ICU), admission to the neonatal intensive care unit (NICU), meconium-stained amniotic fluid, and neonatal Apgar scores at 1 and 5 min. Results No differences were noted in the maternal age, body mass index (BMI) on admission, gestations, parity, gestational weeks at delivery and neonatal birth weight, or the rate of gestational diabetes mellitus (GDM) and hypertension disorder did not significantly differ among the three groups (p > 0.05). The no-NA group had shorter durations of first stage, second stage of labor compared to the early-NA or late-NA group (median, 215.0 min and 10.0 min vs. 300.0 min and 12.0 min vs. 280.0 min and 13.0 min) (p < 0.05), but no differences were observed between the early-NA and late-NA group (p > 0.05). There were no differences in the rate of intrapartum CD, intrapartum fever, PPH, maternal transferred to ICU, neonatal transfer to NICU, meconium-stained amniotic fluid, and postpartum stay ≥ 7d, as well as the neonatal the Apgar scores at 1 and 5 min among the three groups (p > 0.05). Conclusion NA is associated with extended durations of the first, second and total stages of labor. However, the early initiation of NA in multiparous women (cervical dilation within 0.5-2.0 cm) does not increase the risk of intrapartum CD or intrapartum fever. These findings endorse the secure utilization of early NA for pain relief during labor in multiparous women.

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Effects of Epidural Analgesia on Labor Pain and Course of Labor in Primigravid Parturients: A Prospective Non-randomized Comparative Study

Cited by 6 publications

References 25 publications

Efficacy and safety of nalbuphine for epidural labor analgesia at high altitude: An observational study

Efficacy and safety of nalbuphine for epidural labor analgesia at high altitude: An observational study

Evaluation of the effects of epidural labour analgesia on mode of delivery

Effects of early- and late- neuraxial analgesia on multiparous women: a retrospective monocentric study

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