DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20190873

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

Manisha C. Shembekar, Chaitanya A. Shembekar, Shantanu C. Shembekar, Jayshree J. Upadhye

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.


Keywords


Epidural, Labour analgesia, Pain relief, Satisfaction

Full Text:

PDF

References


Silva M, Halpern SH. Epidural analgesia for labor: Current techniques. Local and regional anesthesia. 2010;3:143.

Jouppila R, Hollmen A. The effect of segmental epidural analgesia on maternal and foetal acid‐base balance, lactate, serum potassium and creatine phosphokinase during labour. Acta Anaesthesiologica Scandinavica. 1976;20(3):259-68.

Sng BL, Leong WL , Zeng Y , Siddiqui FJ , Assam PN , Lim Y , Chan ES , Sia AT , Early versus late initiation of epidural analgesia for labour, The Cochrane Database of Systematic Reviews. 2014(10):CD007238.

American College of Obstetricians and Gynecologists. Task Force on Cesarean Delivery Rates. Evaluation of cesarean delivery. Washington DC: American College of Obstetricians and Gynecologists. 2000.

American College of Obstetricians and Gynecologists. Obstetric analgesia and anesthesia. ACOG Practice bulletin No. 36. Obstet Gynecol. 2002;100(1):177-91.

American College of Obstetricians and Gynecologists, Dystocia and augmentation of labor. ACOG Practice Bulletin No. 49. Obstet Gynceol. 2003;102(6):1445-54.

Dei‐ham RJ, Crowhurst J, Crowther C. The second stage of labour: durational dilemmas. Aus New Z J Obstet Gynaecol. 1991;31(1):31-6.

WHO recommendation on epidural analgesia for pain relief during labour.

Cambic CR, Wong CA, Labour analgesia and obstetric outcomes, BJA: Br J Anaesth. 2010;105(1):i50-60.

Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology: J Am Soc Anesthesiol. 1979;51(4):285-7.

Breivik EK, Björnsson GA, Skovlund E. A comparison of pain rating scales by sampling from clinical trial data. Clinic J Pain. 2000;16(1):22-8.

Anim‐Somuah M, Smyth RM, Jones L. Epidural versus non‐epidural or no analgesia in labour. Cochrane database of systematic reviews. 2011(12).

Bogod DG, ROSEN M, REES GA, Extradural Infusion Of 0.125% Bupivacaine to women during labour, Br J Anaesth. 1987;59(3):325-30.

Fyneface-Ogan S, Mato CN, Anya SE. Epidural anesthesia: views and outcomes of women in labor in a Nigerian hospital. Ann Afr Med. 2009;8(4):250-6.

Yancey MK, Pierce B, Schweitzer D, Daniels D. Observations on labor epidural analgesia and operative delivery rates. Am J Obstet Gynecol. 1999;180(2):353-9.

Impey L, MacQuillan K, Robson M. Epidural analgesia need not increase operative delivery rates. American J Obstet Gynecol. 2000;182(2):358-63.

Chhetty YK, Naithani U, Gupta S, Bedi V, Agrawal I, Swain L. Epidural labor analgesia: A comparison of ropivacaine 0.125% versus 0.2% with fentanyl. J Obstetric Anaesthes Critical Care. 2013;3(1):16.

Sheiner E, Shoham-Vardi I, Sheiner EK, Press F, Hackmon-Ram R, Mazor M, Katz M, A comparison between the effectiveness of epidural analgesia and parenteral pethidine during labor. Arch Gynecol Obstet. 2000;263(3):95-8

Dickinson JE, Paech MJ, McDonald SJ, Evans SF, Maternal satisfaction with childbirth and intrapartum analgesia in nulliparous labour. Aust NZJ Obstet Gynaecol. 2003;43(6):463-8.

Leighton BL, Halpern SH. The effects of epidural analgesia on labor, maternal, and neonatal outcomes: a systematic review. Am J Obstet Gynecol. 2002;186(5):S69-77.