DOI: 10.36347/sjams.2014.v02i06.063

Pages: 3155-3160

The pain in labor is arguably the most severe pain most women will endure in their lifetimes. Unrelieved labor pain produces many physiological changes which are detrimental to mother. Various methods have been used to alleviate this pain. It is now well recognized that the only consistently effective method of pain relief in labor is lumbar epidural analgesia. However, there are concerns regarding unintended adverse effects on the mother. Objective of the study was to assess the effects of epidural analgesia when compared with no pain relief during labor. 120 nulliparous women in term labor were assigned to the study and allocated into two groups. Parturients who request epidural analgesia were allocated in the epidural group, whereas those not, in non-epidural group. Epidural analgesia was provided with 0.125% bupivacaine with 2 mcg/ml of fentanyl using a top up dosage technique. Quality of pain relief by VAPS score, duration of the first and second stages of labor, usage of oxytocin, mode of delivery and maternal side effects if any were recorded. Epidural analgesia was found to offer better pain relief with good maternal satisfaction. However, it was associated with an increased risk of assisted vaginal birth and oxytocin administration with no significant variation in duration of labor and cesarean delivery. Epidural analgesia appears to be effective in reducing pain during labor and highest maternal satisfaction with pain relief. However, women who use this form of pain relief are at increased risk of having an instrumental delivery with no statistically significant impact on the risk of cesarean delivery.