Effects of epidural lidocaine analgesia on labor and delivery: A randomized, prospective, controlled trial

Abstract

BackgroundWhether epidural analgesia for labor prolongs the active-first and second labor stages and increases the risk of vacuum-assisted delivery is a controversial topic. Our study was conducted to answer the question: does lumbar epidural analgesia with lidocaine affect the progress of labor in our obstetric population?Method395 healthy, nulliparous women, at term, presented in spontaneous labor with a singleton vertex presentation. These patients were randomized to receive analgesia either, epidural with bolus doses of 1% lidocaine or intravenous, with meperidine 25 to 50 mg when their cervix was dilated to 4 centimeters. The duration of the active-first and second stages of labor and the neonatal apgar scores were recorded, in each patient. The total number of vacuum-assisted and cesarean deliveries were also measured.Results197 women were randomized to the epidural group. 198 women were randomized to the single-dose intravenous meperidine group. There was no statistical difference in rates of vacuum-assisted delivery rate. Cesarean deliveries, as a consequence of fetal bradycardia or dystocia, did not differ significantly between the groups. Differences in the duration of the active-first and the second stages of labor were not statistically significant. The number of newborns with 1-min and 5-min Apgar scores less than 7, did not differ significantly between both analgesia groups.ConclusionEpidural analgesia with 1% lidocaine does not prolong the active-first and second stages of labor and does not increase vacuum-assisted or cesarean delivery rate.

A Comparative Study of 0.125% Ropivacaine With Fentanyl 2 McG/Ml Versus 0.125% Bupivacaine With Fentanyl 2mcg/Ml for Labour Epidural Analgesia

“…Contrary to the popular belief that epidural analgesia causes prolongation of duration of labour, we found statistically significant reduction in the duration of labour in both the study groups, which was also observed by our obstetricians. Similar findings were reported by Khan et al and Nafisi et al 23,24 Reduction in duration of first stage of labour by 2 h was also observed by Lee et al, in the Ropivacaine group. 23 Adverse maternal events and foetal effects were statistically insignificant.…”

“…Similar findings were reported by Khan et al and Nafisi et al 23,24 Reduction in duration of first stage of labour by 2 h was also observed by Lee et al, in the Ropivacaine group. 23 Adverse maternal events and foetal effects were statistically insignificant. we selected intermittent top ups in our study, As per various other studies, 25 drug consumption is less in intermittent top-up doses, which certainly affects the development of motor block, Besides, close monitoring also develops confidence between the patient and the physician, and provides opportunity to recognize the complications immediately.…”

Pre-emptive local analgesia in video-assisted thoracic surgery sympathectomy☆

“…Thus, our result seems to suggest that the failure of regional anaesthesia to block all the input of nociceptors during operation, or early onset of postoperative pain as a result of the use of shorter-acting local anaesthetics, might have contributed to the development of central sensitisation with decrease of the PLA effect following 24 h after the operation. Finally, lidocaine is not as expensive as bupivacaine and the chances of severe complications are less with bupivacaine [23], although these patients are not at higher risk for local anaesthetic toxicity.…”

Cervicographic progress in active Phase and obstetric outcome in Patients undergoing labour under Epidural analgesia

“…[5] 2005 No difference in CS rate Shahram et al [6] 2006 No difference in incidence of instrumental delivery and CS rate with epidural Ching-Chung Liang et al [7] 2007 Significant increase in the CS rate and instrumental delivery with epidural Kukulu et al [8] 2008 No difference in CS rate Hasegawa et al [10] 2013 Significant increase in the CS rate and instrumental delivery with epidural Present study 2013 High incidence of instrument assisted delivery but no difference in CS rate.…”