Epidural medication after the initial dose: reflections on current methods of administration during labour

Most women who receive epidural pain relief during labour require additional epidural analgesia following the initial dose. This review examines the relative merits associated with current methods of epidural drug delivery when further analgesia is required. Apart from considerations of patient safety and convenience the review compares the relative flexibility in pain management which can be provided by these different regimens. It is postulated that patient satisfaction is enhanced when the mother has some personal control over the density of neural blockade provided by epidural analgesia.