Labour with low dose epidural analgesia: maternal perception and fetal outcome

Sawant, Vasudha; Kumbhar, Archana

doi:10.18203/2320-1770.ijrcog20180195

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…(Gp. B) supported by Vasudha et al [8] & Agarwal D et al [4]. In current study, the second stage was found to be prolonged in epidural group as compared to control.…”

Section: Discussionsupporting

confidence: 74%

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A Prospective Cohort Study Analysing Maternal & Foetal Outcome of Epidural Analgesia in Primiparous- A Boon or Bane!

Choudhary

2018

JAICM

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Introduction: Childbirth is a multidimensional experience and when considering treatment, one must balance between pain relief and other aspects, such as physical, emotional, psychological, sociologic, and sometimes religious considerations. In other words, pain relief may not be enough to make childbirth a fulfilling and satisfactory experience. In this section we will consider the goals of therapy for labor pain and how neuraxial analgesia helps to accomplish these goals. The aim of the study was to evaluate the effect of epidural analgesia on duration of labor, maternal and foetal outcome. Methodology:The present study was a prospective cohort study conducted in a tertiary care hospital in Dept. of obstetrics & gynaecology. Registration of patients was from August 2016 to July 2017. The women in labor who have fulfilled inclusion criteria are enrolled in the study. They were counselled when they were admitted in labor room, during 1st stage of labor. Detailed history was taken according to the proforma. General physical examination done. Systemic examination including per cephalopelvic disproportion. The primary outcome was duration of labor (first and second stage of labor). Secondary outcome measures were the incidence of vaginal delivery, caesarean sections and instrumental vaginal delivery. Neonatal outcome in form of APGAR score at 5 min noted.Result: Both the groups were matched with respect to characters like maternal age, height, weight, gestational age. Total number of patients in this study were 40. Majority of patients were between 20-26 years with mean age of 23.45 years & 24.45 yrs in epidural & control Gp. respectively. Results of present study demonstrated that epidural analgesia provides excellent pain relief. There was statistically significant difference in mean duration of first stage of labor in both groups with p value of <0.05 which is statistically significant. In regard of mode of delivery there was no Statistically significant difference observed in both groups. Perception of pain in EA group was very low with 100% of patients giving good VAS score. Patients acceptability in EA group was 100 % all of them were interested to take epidural analgesia in next labor. Conclusion:Epidural analgesia is commonly performed to relieve labor pain. Compared with other techniques, it is the most effective form of analgesia. Recent innovations in drug combinations and delivery systems have resulted in a flexible technique that meets the needs of most parturients in a safe and effective manner.

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“…(Gp. B) supported by Vasudha et al [8] & Agarwal D et al [4]. In current study, the second stage was found to be prolonged in epidural group as compared to control.…”

Section: Discussionsupporting

confidence: 74%

“…There was statistically significant difference in mean duration of first stage of labor in both groups with p value of <0.05 which is statistically significant, as opposed to study by Wong FM et al [3] & Vasudha et al [8]. Second stage of labor was slightly prolonged in Epidural gp.…”

Section: Discussioncontrasting

confidence: 63%

A Prospective Cohort Study Analysing Maternal & Foetal Outcome of Epidural Analgesia in Primiparous- A Boon or Bane!

Choudhary

2018

JAICM

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“…It could be explained by the fact that the epinephrine levels are reduced by epidural analgesia resulting in decreased adrenergic receptor stimulation leading to enhanced uterine perfusion and more effective contraction. [ 12 13 14 ]…”

Section: Discussionmentioning

confidence: 99%

Evaluating the effectiveness of TENS for maternal satisfaction in laboring parturients – Comparison with epidural analgesia

Gupta

Kaur

et al. 2020

J Anaesthesiol Clin Pharmacol

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Background and Aims: Labor pain is one of the most severe pain that a woman experiences in her lifetime. Various methods are being used to relieve this pain and to achieve higher maternal satisfaction. One such technique is transcutaneous electrical nerve stimulation (TENS) that uses low-frequency electrotherapy. The aim of our study was to evaluate TENS by comparing it to an established labor analgesia technique, i.e., epidural analgesia in terms of maternal satisfaction. Material and Methods: This prospective study was conducted on 60 parturients in active stage of labor. The choice of analgesia was made by the parturient after informed consent. In group A (n = 30) TENS was used, while in group B (n = 30) epidural ropivacaine 0.125% + 2 μg/ml fentanyl was given. Continuous monitoring of maternal vitals, visual analogue score, and fetal heart rate (FHR) was done. Maternal satisfaction was scored considering pain relief, ability to move and experience of labor at the end of delivery and outcome was labeled as favorable and unfavorable. Results: TENS was found to be favorable in 90% of parturients as compared to 96.6% in epidural ( P 0.301). The number of highly satisfied parturients was 4 (13.3%) in TENS group and 17 (56.6%) in the epidural group ( P = 0.000). Three patients in the epidural group had assisted delivery and two had cesarean section whereas all patients in TENS group delivered normally ( P = 0.065). No significant difference was found in the fetal outcome. Conclusions: TENS is a good alternate choice for providing labor analgesia and may have a major role in future.

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“…In a study conducted by Sawant V Kumbhar A. concluded Epidural analgesia appears to have significant pain relief as compared to no analgesia during labour. 33…”

Section: Pain Reliefmentioning

confidence: 99%

Epidural Analgesia in Labour and Its Obstetric Outcome

Sheela

Kiran

2022

Preprint

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• Introduction: Labour is a natural phenomenon which produces intolerable pain that requires effective methods for pain relief which is often challenging and complex task without regional analgesia. Epidural analgesia is most widely accepted method used to reduce labour pain. • Aims and Objectives: Assessment of epidural analgesia in pain relief during labour, duration of different stages of labour, maternal and foetal outcome. • Methodology: This study is a Prospective Observational study conducted at RL JALAPPA Hospital, Kolar from January 2020 to June 2021.40 women admitted for normal vaginal delivery opting labour analgesia were studied. Data collected was entered in Microsoft excel spread sheet and results were analysed. • Results: The mean duration of first stage of labour was153 minutes, mean duration of second stage was 30minutes, and mean duration of third stage was 12 minutes. During first stage of labour, 20 women (52%) had no pain, 12 women (31%) had mild pain and 6 women (15%) had moderate pain. During second stage of labour, 16 women (42%) had mild pain, 15 women (39%) had no pain and 7 women (18%) had moderate pain .During third stage of labour, 30 women (78.9%) had no pain and 8 women (21%) had mild pain. The mean Apgar score of all babies at 1 minute was 7/10 and 5 minute was 9/10. • Conclusion: Epidural analgesia is a safe and effective technique during labour and provides significant pain relief with excellent patient satisfaction.

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Labour with low dose epidural analgesia: maternal perception and fetal outcome

Cited by 7 publications

References 6 publications

A Prospective Cohort Study Analysing Maternal & Foetal Outcome of Epidural Analgesia in Primiparous- A Boon or Bane!

A Prospective Cohort Study Analysing Maternal & Foetal Outcome of Epidural Analgesia in Primiparous- A Boon or Bane!

Evaluating the effectiveness of TENS for maternal satisfaction in laboring parturients – Comparison with epidural analgesia

Epidural Analgesia in Labour and Its Obstetric Outcome

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