Impact of Epidural Analgesia on labour: A Review
Keywords:
Epidural analgesia, Labour, Pain, Delivery, Safe,
Abstract
Pain relief in labour has always been surrounded with myths and controversies. Hence, providing effective and safe analgesia during labour has remained an ongoing challenge. Relief of labour pain has always been a point of debate in the society ever since the use of ether by J.Y. Simpson in 1846 to regional analgesia in 20th century. Impact of labour analgesia on the progress and mode of delivery has become a crucial subject of debate among obstetric and anesthesia care providers during the last few decades. A large number of unrandomized and retrospective studies have been done to assess the effects of epidural and parenteral analgesia on duration and mode of deliveries.Epidural is a safe method to address the fear of pain associated with labour hence it should be explained to every primigravida during her antenatal period and she should be allowed to make knowledgeable choice.References
1. Moir DD. Extradural analgesia for caesarean section. Br J Anaesth. 1979 Feb;51(2):79–80.
2. Melzack R. The myth of painless childbirth (the John J. Bonica lecture). Pain 1984;19:321-337
3. ACOG committee opinion No. 295: pain relief during labour. Obstet Gynecol 2004;104:213-213
4. A brief history of pain relief in labour. Available at http:// www.papapetros.com.au/HistoryPain Relief.pdf
5. Danforth's Obstetrics and Gynecology. Ronald S. Gibbs et al. Lippincott Williams & Wilkins. 10th edition, 2008. Chapter 2
6. F. Carli, P. Creagh-Barry, H. Gordon, Margaret M. Logue, Caroline J. Dore: Does epidural analgesia influence the mode of delivery in primiparae managed actively? A preliminary study of 1250 women. International Journal of Obstetric Anesthesia 1993; 2(1); 15-20
7. Thorp JA et al: Effect of epidural analgesia on nulliparous labour- A Randomized Controlled prospective trial. American journal of obstetrics and gynaecology: 169 (4) 851-858 oct 1993.
8. Chestnut DH et al: Does early administration of epidural analgesia affect obstetric outcome in nulliparous women who are in spontaneous labour? Anesthesiology 1994; 80 (6); 1201-8.
9. Rudolf Stienstra et al: Ropivacaine 0.25% versus Bupivacaine 0.25% for continuous Epidural Analgesia in Labour: A Double-Blind Comparison, Anesth Analg 1995; 80: 285-9.
10. Bofill JA et al: Nulliparous active labour, epidural analgesia and caesarean delivery for dystocia. American journal of obstetrics and gynaecology. 1997 Dec; 177 (6); 1465-70.
11. Halpern SH, Leighton BL Ohlsson A, Barrett JF, Rice A. Effect of epidural vs parenteral opioid analgesia on the progress of labour: a meta-analysis. JAMA 1998; 280: 2105-2110
12. Zimmer EZ et al: Adverse effects of epidural analgesia. European journal of obstetrics and gynaecology 2000 April; 89 (2); 153-7
13. Loughnan BA, Carli F, Romney M, DorØ CJ, Gordon H. Randomized controlled comparison of epidural bupivacaine versus pethidine for analgesia in labour. Br J Anaesth 2000; 84: 715719
14. C.J. Howell, C. Kidd, W. Roberts, P. Upton, L. Lucking, P.W. Jones and R.B. Johanson A randomised controlled trial of epidural compared with non-epidural analgesia in labour. BJOG: An International Journal of Obstetrics & Gynaecology 2001; 108(1);27–3.
15. Barbara L. Leighton, Stephen H. Halpern: The effects of epidural analgesia on labour, maternal, and neonatal outcomes: A systematic review. Am J Obstet Gynecol 2002;186:S69-77.
16. Sharma SK et al: Labour analgesia and caesarean delivery: an individual patient meta-analysis of nulliparous women. Anesthesiology. 2004 Jan; 100 (1): 142-8 discussion 6A.
17. Liu EH, Sia AT: Rates of caesarean section and instrumental vaginal delivery in nulliparous women after low concentration epidural infusions or opioid analgesia: systematic review. BMJ 2004 Jun 12;328(7453):1410.
18. Fernandez-Guisasola: Obstetric epidural analgesia: relationship between obstetric variables and the course of labour. Rev Esp Asnestesiol Reanim. 2004 March: 51(3): 121-7
19. Sienko J et al: epidural analgesia and course of delivery in term primiparas, Ginekol pol. 2005
20. Halpern et al. Epidural analgesia and the progress of labour 2009. hptt://www.manbit.com/oa/c102.htm
21. Anim Souman M, Smyth R, Howell C: Epidural versus non-epidural or no analgesia in labour (Review). The Cochrane Database of systematic Review 2005, issue 4.
22. Wu CY, Ren LR, Wang ZH: Effects of epidural ropivacaine labour analgesia on duration of labour and mode of delivery. Zhonghua Fu Chan Ke Za Zhi. 2005 Jun;40(6):369-71.
23. Zhang M, Yang HX, Li HY, Shi HX, Qu Y: Influence of combined spinal-epidural analgesia and epidural analgesia on the progress of labour. Zhonghua Fu Chan Ke Za Zhi. 2005 Jun;40(6):365-8
24. Wong CA, Scavone BM, Peaceman AM, et al. The risk of caesarean delivery with neuraxial analgesia given early versus late in labour. N Engl J Med 2005; 352: 655-665
25. Shahram Nafisi: Effects of epidural lidocaine analgesia on labour and delivery: A randomized, prospective, controlled trial. BMC Anesthesiology 2006, 6:15
26. Gonen Ohel, Roni Gonen, Sonia Vaida, Shlomi Barak, Luis Gaitini. Early versus late initiation of epidural analgesia in labour: Does it increase the risk of caesarean section? A randomized trial. American Journal of Obstetrics and Gynecology (2006) 194, 600–5
27. Liang CC: Does intrapartum epidural analgesia affect nulliparous labour and postpartum urinary incontinence? Chang GUNG Medical J. 2007 Mar-Apr; 30(2); 161-7
28. Bakhamees H, Hegazy E: Does epidural increase the incidence of caesarean delivery or instrumental labour in Saudi populations? Middle East J Anesthesiol 2007 Oct;19(3):693-704
29. Raja KS, Tasleem H. Influence of epidural analgesia on frequency of instrumental delivery and duration of labour, Rewal Medical J. 2009; 34 (1) : 86-88
30. Wang F, Shan X, Guo X, Peng Y, Gu X. Epidural analgesia in the latent phase of labour and the risk of caesarean delivery: a five-year randomized controlled trial. Anesthesiology 2009; 111: 871880
31. Fyneface-Ogan S, Mato CN, Anya SE. Epidural anesthesia: views and outcomes of women in labour in a Nigerian hospital. Ann Afr Med 2009; 8: 250-256
32. Fouzia Anwer, Shazia Shukar-Ud-Din, Gulishan Haq: Fetomaternal outcome of epidural analgesia during labour. J Surg Pakistan 2010; 15:151-54
33. Wassen MM, Zuijlen J, Roumen FJ, Smits LJ, Marcus MA, Nijhuis JG: Early versus late epidural analgesia and risk of instrumental delivery in nulliparous women: a systematic review. BJOG 2011 May;118(6):655-61
34. Anim-Somuah M, Smyth RM, Jones L: Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev 2011 Dec 7
35. D. Kothari, J. Bindal. Impact of obstetric analgesia (regional vs parenteral) on progress and outcome of labour: a review. J Rom Anest Terap Int 2011; 18: 34-40
36. Wesam Farid Mousa, Roshdi Al-Metwalli, and Manal Mostafa. Epidural analgesia during labour vs no analgesia: A comparative study. Saudi J Anaesth. 2012 Jan-Mar; 6(1): 36–40
37. Agrawal D, Makhija B, Arora M, Haritwal A, Gurha P. The Effect of Epidural Analgesia on Labour, Mode of Delivery and Neonatal Outcome in Nullipara of India, 2011-2014. Journal of Clinical and Diagnostic Research : JCDR. 2014;8(10):OC03-OC06. doi:10.7860/JCDR/2014/9974.4930.
38. Philipsen T, Jensen NH. Epidural block or parenteral pethidine as analgesic in labour: a randomized study concerning progress in labour and instrumental deliveries. Eur J Obstet Gynecol Reprod Biol 1989; 30: 27-33
39. Thorp JA, Eckert LO, Ang MS, Johnston DA, Paceman AM, Parisi VM. Epidural analgesia and caesarean section for dystocia: risk factors in nulliparas. Am J Perinatol 1991; 8: 402-410
40. Ramin SM, Gambling DR, Lucas MJ, Sharma SK, Sidawi JE, Leveno KJ. Randomized trial of epidural versus intravenous analgesia during labour. Obstet Gynecol 1995; 86: 783-789
41. Sharma SK, Sidawi JE, Ramin SM, Lucas MJ, Leveno KJ, Cunningham FG. Caesarean delivery: a randomized trial of epidural versus patient-controlled meperidine analgesia during labour. Anesthesiology 1997; 87: 487-494
42. Halpern SH, Abdallah FW. Effect of labour analgesia on labour outcome. Curr Opin Anaesthesiol 2010; 23: 317-322
43. Zhang J, Klebanoff MA, DerSimonian R. Epidural analgesia in association with duration of labour and mode of delivery: a quantitative review. Am J Obstet Gynecol 1999; 180: 970-977
44. Studd JW, Crawford JS, Duignan NM, Rowbotham CJ, Hughes AO. The effect of lumbar epidural analgesia on the rate of cervical dilatation and the outcome of labour of spontaneous onset. Br J Obstet Gynaecol 1980; 87: 1015-1021
45. Loughnan BA, Carli F, Romney M, DorØ CJ, Gordon H. Randomized controlled comparison of epidural bupivacaine versus pethidine for analgesia in labour. Br J Anaesth 2000; 84: 715719
46. Clark A, Carr D, Loyd G, Cook V, Spinnato J. The influence of epidural analgesia on caesarean delivery rates: a randomized, prospective clinical trial. Am J Obstet Gynecol 1998; 179: 15271533
2. Melzack R. The myth of painless childbirth (the John J. Bonica lecture). Pain 1984;19:321-337
3. ACOG committee opinion No. 295: pain relief during labour. Obstet Gynecol 2004;104:213-213
4. A brief history of pain relief in labour. Available at http:// www.papapetros.com.au/HistoryPain Relief.pdf
5. Danforth's Obstetrics and Gynecology. Ronald S. Gibbs et al. Lippincott Williams & Wilkins. 10th edition, 2008. Chapter 2
6. F. Carli, P. Creagh-Barry, H. Gordon, Margaret M. Logue, Caroline J. Dore: Does epidural analgesia influence the mode of delivery in primiparae managed actively? A preliminary study of 1250 women. International Journal of Obstetric Anesthesia 1993; 2(1); 15-20
7. Thorp JA et al: Effect of epidural analgesia on nulliparous labour- A Randomized Controlled prospective trial. American journal of obstetrics and gynaecology: 169 (4) 851-858 oct 1993.
8. Chestnut DH et al: Does early administration of epidural analgesia affect obstetric outcome in nulliparous women who are in spontaneous labour? Anesthesiology 1994; 80 (6); 1201-8.
9. Rudolf Stienstra et al: Ropivacaine 0.25% versus Bupivacaine 0.25% for continuous Epidural Analgesia in Labour: A Double-Blind Comparison, Anesth Analg 1995; 80: 285-9.
10. Bofill JA et al: Nulliparous active labour, epidural analgesia and caesarean delivery for dystocia. American journal of obstetrics and gynaecology. 1997 Dec; 177 (6); 1465-70.
11. Halpern SH, Leighton BL Ohlsson A, Barrett JF, Rice A. Effect of epidural vs parenteral opioid analgesia on the progress of labour: a meta-analysis. JAMA 1998; 280: 2105-2110
12. Zimmer EZ et al: Adverse effects of epidural analgesia. European journal of obstetrics and gynaecology 2000 April; 89 (2); 153-7
13. Loughnan BA, Carli F, Romney M, DorØ CJ, Gordon H. Randomized controlled comparison of epidural bupivacaine versus pethidine for analgesia in labour. Br J Anaesth 2000; 84: 715719
14. C.J. Howell, C. Kidd, W. Roberts, P. Upton, L. Lucking, P.W. Jones and R.B. Johanson A randomised controlled trial of epidural compared with non-epidural analgesia in labour. BJOG: An International Journal of Obstetrics & Gynaecology 2001; 108(1);27–3.
15. Barbara L. Leighton, Stephen H. Halpern: The effects of epidural analgesia on labour, maternal, and neonatal outcomes: A systematic review. Am J Obstet Gynecol 2002;186:S69-77.
16. Sharma SK et al: Labour analgesia and caesarean delivery: an individual patient meta-analysis of nulliparous women. Anesthesiology. 2004 Jan; 100 (1): 142-8 discussion 6A.
17. Liu EH, Sia AT: Rates of caesarean section and instrumental vaginal delivery in nulliparous women after low concentration epidural infusions or opioid analgesia: systematic review. BMJ 2004 Jun 12;328(7453):1410.
18. Fernandez-Guisasola: Obstetric epidural analgesia: relationship between obstetric variables and the course of labour. Rev Esp Asnestesiol Reanim. 2004 March: 51(3): 121-7
19. Sienko J et al: epidural analgesia and course of delivery in term primiparas, Ginekol pol. 2005
20. Halpern et al. Epidural analgesia and the progress of labour 2009. hptt://www.manbit.com/oa/c102.htm
21. Anim Souman M, Smyth R, Howell C: Epidural versus non-epidural or no analgesia in labour (Review). The Cochrane Database of systematic Review 2005, issue 4.
22. Wu CY, Ren LR, Wang ZH: Effects of epidural ropivacaine labour analgesia on duration of labour and mode of delivery. Zhonghua Fu Chan Ke Za Zhi. 2005 Jun;40(6):369-71.
23. Zhang M, Yang HX, Li HY, Shi HX, Qu Y: Influence of combined spinal-epidural analgesia and epidural analgesia on the progress of labour. Zhonghua Fu Chan Ke Za Zhi. 2005 Jun;40(6):365-8
24. Wong CA, Scavone BM, Peaceman AM, et al. The risk of caesarean delivery with neuraxial analgesia given early versus late in labour. N Engl J Med 2005; 352: 655-665
25. Shahram Nafisi: Effects of epidural lidocaine analgesia on labour and delivery: A randomized, prospective, controlled trial. BMC Anesthesiology 2006, 6:15
26. Gonen Ohel, Roni Gonen, Sonia Vaida, Shlomi Barak, Luis Gaitini. Early versus late initiation of epidural analgesia in labour: Does it increase the risk of caesarean section? A randomized trial. American Journal of Obstetrics and Gynecology (2006) 194, 600–5
27. Liang CC: Does intrapartum epidural analgesia affect nulliparous labour and postpartum urinary incontinence? Chang GUNG Medical J. 2007 Mar-Apr; 30(2); 161-7
28. Bakhamees H, Hegazy E: Does epidural increase the incidence of caesarean delivery or instrumental labour in Saudi populations? Middle East J Anesthesiol 2007 Oct;19(3):693-704
29. Raja KS, Tasleem H. Influence of epidural analgesia on frequency of instrumental delivery and duration of labour, Rewal Medical J. 2009; 34 (1) : 86-88
30. Wang F, Shan X, Guo X, Peng Y, Gu X. Epidural analgesia in the latent phase of labour and the risk of caesarean delivery: a five-year randomized controlled trial. Anesthesiology 2009; 111: 871880
31. Fyneface-Ogan S, Mato CN, Anya SE. Epidural anesthesia: views and outcomes of women in labour in a Nigerian hospital. Ann Afr Med 2009; 8: 250-256
32. Fouzia Anwer, Shazia Shukar-Ud-Din, Gulishan Haq: Fetomaternal outcome of epidural analgesia during labour. J Surg Pakistan 2010; 15:151-54
33. Wassen MM, Zuijlen J, Roumen FJ, Smits LJ, Marcus MA, Nijhuis JG: Early versus late epidural analgesia and risk of instrumental delivery in nulliparous women: a systematic review. BJOG 2011 May;118(6):655-61
34. Anim-Somuah M, Smyth RM, Jones L: Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev 2011 Dec 7
35. D. Kothari, J. Bindal. Impact of obstetric analgesia (regional vs parenteral) on progress and outcome of labour: a review. J Rom Anest Terap Int 2011; 18: 34-40
36. Wesam Farid Mousa, Roshdi Al-Metwalli, and Manal Mostafa. Epidural analgesia during labour vs no analgesia: A comparative study. Saudi J Anaesth. 2012 Jan-Mar; 6(1): 36–40
37. Agrawal D, Makhija B, Arora M, Haritwal A, Gurha P. The Effect of Epidural Analgesia on Labour, Mode of Delivery and Neonatal Outcome in Nullipara of India, 2011-2014. Journal of Clinical and Diagnostic Research : JCDR. 2014;8(10):OC03-OC06. doi:10.7860/JCDR/2014/9974.4930.
38. Philipsen T, Jensen NH. Epidural block or parenteral pethidine as analgesic in labour: a randomized study concerning progress in labour and instrumental deliveries. Eur J Obstet Gynecol Reprod Biol 1989; 30: 27-33
39. Thorp JA, Eckert LO, Ang MS, Johnston DA, Paceman AM, Parisi VM. Epidural analgesia and caesarean section for dystocia: risk factors in nulliparas. Am J Perinatol 1991; 8: 402-410
40. Ramin SM, Gambling DR, Lucas MJ, Sharma SK, Sidawi JE, Leveno KJ. Randomized trial of epidural versus intravenous analgesia during labour. Obstet Gynecol 1995; 86: 783-789
41. Sharma SK, Sidawi JE, Ramin SM, Lucas MJ, Leveno KJ, Cunningham FG. Caesarean delivery: a randomized trial of epidural versus patient-controlled meperidine analgesia during labour. Anesthesiology 1997; 87: 487-494
42. Halpern SH, Abdallah FW. Effect of labour analgesia on labour outcome. Curr Opin Anaesthesiol 2010; 23: 317-322
43. Zhang J, Klebanoff MA, DerSimonian R. Epidural analgesia in association with duration of labour and mode of delivery: a quantitative review. Am J Obstet Gynecol 1999; 180: 970-977
44. Studd JW, Crawford JS, Duignan NM, Rowbotham CJ, Hughes AO. The effect of lumbar epidural analgesia on the rate of cervical dilatation and the outcome of labour of spontaneous onset. Br J Obstet Gynaecol 1980; 87: 1015-1021
45. Loughnan BA, Carli F, Romney M, DorØ CJ, Gordon H. Randomized controlled comparison of epidural bupivacaine versus pethidine for analgesia in labour. Br J Anaesth 2000; 84: 715719
46. Clark A, Carr D, Loyd G, Cook V, Spinnato J. The influence of epidural analgesia on caesarean delivery rates: a randomized, prospective clinical trial. Am J Obstet Gynecol 1998; 179: 15271533
Published
2015-11-18
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