The use of epidural Bupivacaine for the relief of childbirth pain

Abstract

Epidural anaesthesia is now a widely used method for pain relief in childbirth, particularly using the drug Bupivacaine. There are nevertheless differing opinions in the research literature about the advisability of its routine use. While it is clearly very effective in relieving labour pain, there are some consistent, troublesome patterns; for example, a strong association between epidural use and other interventions, such as instrumental delivery. Further, there are no clear answers from the research to date concerning the risks and benefits of epidural anaesthesia for infant and mother. Answers could be provided by randomized clinical trials, but meanwhile a conservative approach to its use is recommended for uncomplicated labours.

Applying stages of change theory to an acute pain situation: Development of the Childbirth Stages of Change Questionnaire (CSOCQ)

“…Poole (2003) Epidural anesthesia, currently the most requested form of pharmacological intervention (Howell et al, 2001), has been demonstrated to be an effective pain relief method for discomfort during childbirth (Klein, 2006). Bennett, Lumley, and Bartlett (1987) reviewed the technique, indications, and incidence of epidural anesthesia. Although a highly effective form of pain management, Bennett and colleagues noted that the routine use of epidural anesthesia has not been empirically supported in randomized clinical trials because epidurals have been associated with fetal malposition, longer labors, and additional interventions, such as instrumental delivery.…”