EPIDURAL ANALGESIA IN LABOUR

Abstract

Introduction: In modern obstetrics, alleviation of labour pains by
simple, safe and effective means presents a unique problem. Epidural analgesia has emerged as a popular and
relatively safe option in this context. It requires injection of local anaesthetic agent into epidural space, which is
commonly approached through lumber intervertebral space. Objective: Aim of study was to determine effect of epidural
analgesia on progress of labour and mode of delivery, to find out its complications in labour and puerperium and to
evaluate neonatal out come in terms of apgar score. Setting: Obstetrics and Gynaecology, Nishtar Hospital, Multan.
Period: one year. Material and methods: Sample size: 50 patients. Results: Out of 50 patients, 4 (8%) were below
20 years of age, 8 (16%) over 30 years of age and 17(34%) patients were 25-29 years of age. Highest percentage was
21-24 years of age i.e. 21(42%) patients. 43 (86%) patients were primi-gravida, 2 (4%) patients had one spontaneous
abortion and 5 (10%) patient were second gravida. Three (25%) patients (1-49 with 95% Cl) were induced for PIH with
no evidence of coagulopathy and fetal compromise. Fifteen (30%) of patients (14-34 with 95% CI) required no
augmentation with oxytocin. In 29 (58%) of patients although duration less than 8 hours but labour was augmented with
syntocinon. In 2 (11% patients instrumental delivery was performed due to meconium stained liquor and persistent
bradycardia. Highest percentage of patients 89% had instrumental delivery because of prolonged second stage.
Conclusion: Epidural analgesia provides excellent pain relief in great majority of patients. Maternal fatigue and distress
with all of its ill effects on labour and puerperium is abolished.