Evaluation of pain relief and satisfaction in women using epidural analgesia in labour

Abstract

INTRODUCTIONNeuraxial analgesia includes spinal, epidural, and combined spinal-epidural analgesia. Epidural analgesia refers to local anesthetics and adjuvant injected into the epidural space. Spinal anesthesia refers to local anesthetic, with or without adjuvant, injected into the subarachnoid space. Combined spinal-epidural analgesia includes analgesia initiated with an intrathecal injection and then epidural catheter is inserted to provide a route for additional drug in order to maintain analgesia. Here, the spinal component provides rapid analgesia with very little motor block of the lower extremities and then an epidural catheter is placed to ensure that analgesia is available throughout labor. 1 Neuraxial techniques are the ABSTRACT Background: Pain during childbirth is the most severe pain women may experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour. Methods: This retrospective study was carried out at Omega Hospital, Nagpur in 50 women in labour who demanded epidural analgesia for pain relief. It was carried out to determine extent of pain relief and overall satisfaction in women using epidural analgesia. Results: In present study, out of 50, 28 (56%) patients delivered by normal vaginal delivery, 14 (28%) patients delivered by cesarean section, 8 (16%) patients had vacuum delivery while in no patient forceps were applied. In first stage,36 (72%) patients had zero score (no pain), 13 (26%) patients had 1-3 score (mild pain) while 1 (2%) patient had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had very good effect in first stage in terms of pain scoring. In second stage, 13 (26%) patients had zero score (no pain), 31 (62%) had 1-3 score (mild pain) while 6 (12%) had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had good effect in second stage in terms of pain scoring. In terms of satisfaction, 11 (22%) patients said it was excellent, 27 (54%) patients said it was good, 8 (16%) patients said it was average while 4 (8%) said it was poor. Apgar score for all babies at 1 min and 5 min was very good. It was ≥7 in all 50 (100%) of newborn babies. Conclusions: Epidural labor analgesia gives significantly less pain scores and has better maternal satisfaction. It is not associated with increased rate of instrumental vaginal delivery or cesarean delivery. Patients had excellent neonatal outcome.