Related Experiment Video
Updated: May 24, 2026
03:14
Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
Epidural analgesia during labor vs no analgesia: A comparative study
Wesam Farid Mousa1, Roshdi Al-Metwalli, Manal Mostafa
1Department of Anesthesia, Dammam University, Kingdom of Saudi Arabia.
Saudi Journal of Anaesthesia
|March 14, 2012
Summary
Epidural analgesia using lidocaine and fentanyl does not prolong labor compared to no analgesia. However, higher oxytocin doses are needed for women receiving epidural pain relief during childbirth.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Pain Management
Background:
- Epidural analgesia is often associated with prolonged labor, but previous studies compared it to systemic opioids, not to women receiving no pain relief.
- This study addresses the gap by comparing epidural analgesia to no analgesia in nulliparous women.
Purpose of the Study:
- To evaluate the effect of epidural analgesia on labor duration in nulliparous women compared to those receiving no analgesia.
- To assess other labor outcomes including instrumental delivery, cesarean rates, and neonatal Apgar scores.
Main Methods:
- 160 nulliparous women in spontaneous labor were assigned to either an epidural group (lidocaine 0.5% and fentanyl) or a control group (no analgesia).
- Labor duration, need for oxytocin, delivery interventions (instrumental, vacuum, cesarean), and neonatal Apgar scores were recorded.
Main Results:
- No significant differences were found in the duration of the first or second stages of labor, rates of instrumental, vacuum, or cesarean deliveries, or neonatal Apgar scores between groups.
- The epidural group required a significantly higher maximal dose of oxytocin.
Conclusions:
- Epidural analgesia with lidocaine and fentanyl does not prolong labor compared to no analgesia in nulliparous women.
- However, increased oxytocin augmentation is necessary to maintain labor progression in women receiving epidural analgesia.
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:25Analgesia and Pain Management
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...