The effect of intrapartum epidural analgesia on nulliparous labor: a randomized, controlled, prospective trial.

Abstract

OBJECTIVE:

Our purpose was to determine the effect of epidural analgesia on nulliparous labor and delivery.

STUDY DESIGN:

Normal term nulliparous women in early spontaneous labor were randomized to receive either narcotic or epidural analgesia.

RESULTS:

When compared with the group receiving narcotic analgesia (n = 45), the group receiving epidural analgesia (n = 48) had a significant prolongation in the first and second stages of labor, an increased requirement for oxytocin augmentation, and a significant slowing in the rate of cervical dilatation. Epidural analgesia was associated with a significant increase in malposition (4.4% vs 18.8%, p < 0.05). Cesarean delivery occurred more frequently in the epidural group (2.2% vs 25%, p < 0.05), primarily related to an increase in cesarean section for dystocia (2.2% vs 16.7%, p < 0.05).

CONCLUSIONS:

In a randomized, controlled, prospective trial epidural analgesia resulted in a significant prolongation in the first and second stages of labor and a significant increase in the frequency of cesarean delivery, primarily related to dystocia.

• Authors: J A Thorp, D H Hu, R M Albin, J McNitt, B A Meyer, G R Cohen, J D Yeast
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 169 Issue 4 Pg. 851-8 (Oct 1993) ISSN: 0002-9378 [Print] United States
• PMID: 8238138 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Oxytocin
• Meperidine
• Promethazine
• Bupivacaine

Topics

• Adult
• Analgesia, Epidural (adverse effects)
• Analgesia, Obstetrical (adverse effects)
• Analysis of Variance
• Apgar Score
• Bupivacaine (adverse effects, therapeutic use)
• Cesarean Section (statistics & numerical data)
• Delivery, Obstetric
• Female
• Fetal Blood (chemistry, drug effects)
• Humans
• Injections, Intravenous
• Labor Presentation
• Labor, Obstetric (drug effects)
• Meperidine (administration & dosage, therapeutic use)
• Oxytocin (therapeutic use)
• Pain Measurement
• Parity
• Pregnancy
• Promethazine (administration & dosage, therapeutic use)
• Prospective Studies
• Time Factors