The influence of patient-controlled epidural analgesia on labor progress and neonatal outcome

Abstract

Abstract Aim: The aim of the study was to check the influence of patient control epidural analgesia on labor progress and neonatal outcome. Material and methods: 144 parturients were included into the clinical trial. In 73 cases patient control epidural analgesia was used and in 71 cases pethidine (meperidine) solution was given intravenously. Apgar score, umbilical artery pH, pain intensity, the time of the first, second and third stage of labor, the rate of episiotomy and uterine postpartum abrasions and the rate of caesarean sections and vaginal operative delivery were compared. Results: The time of the second stage of labor was significantly longer in the study group (40.99 vs 26.49min, p-<0,005), the neonatal outcome was comparable in both groups. There were no differences in the time of the first and the second stage of labor in primiparas and multiparas analyzed separately. Visual Analogue Score was lower in the study group (Ch2-12,48, p-0,25), especially in the subgroups of primiparas and multiparas. Conclusions: Patient control epidural analgesia does not affect the time of the first and second stage of labor, oxytocin augmentation of labor may be the reason of that. This method is a more effective way of relieving labor pain. An increase of operative delivery is not observed after patient control epidural analgesia on condition that low doses and concentrations of an-algesic drugs are used.