Epidural analgesia during labor

Abstract

Introduction: Pain associated with labor affects every woman and it leads to maternal and fetal alterations that may interfere with its normal course.

Epidural analgesic techniques are available to control such pain. Their results are satisfactory to patients and they are associated with favorable outcomes. However, they have seldom been used in the Cauca department of Colombia.

Objective: To describe the experience with the use of epidural analgesia in obstetrical patients at a university hospital in Colombia.

Materials and methods: A descriptive case series study was carried out during two months in 2006, in Popayán, Colombia. Data were collected on 41 patients admitted in the process of labor who were offered and accepted the use of epidural analgesia.

Variables on the clinical situation of the patients, the evolution of labor, and the maternal and fetal outcomes were evaluated. Analyses were performed by means of descriptive statistics.

Results: Average age of the patients was 23.4 years; 65.9% of them were nulliparous, and 85.4% had term pregnancies. At the moment of the dural puncture the mode of cervical dilation was 6 cm and that of pain on a visual analog scale was 8. Average latency time (between the application of the drug and the start of its effect) was 14.1 minutes. 95.1% of the patients required a reinforcement applied on the average 80 minutes after the induction of analgesia and 61%, a second reinforcement administered on the average 49 minutes after the first. Delivery was vaginal in 36 patients and by cesarean section in 5. Adaptation of all newborns was successful: the mode of the Apgar scale at one minute was 9.

Conclusions: Our results agree with those of other studies in that epidural analgesia is an effective way to control labor pain.