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Epidural anesthesia: Views and outcomes of women in labor in a Nigerian hospital
Background: Pain during childbirth is a well known cause of dissatisfaction amongst women in labor. The use of epidural analgesia in labor is becoming widespread due to its benefit in terms of pain relief. Method: After approval of the local Ethics Committee on Research and obtaining informed writte...
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Published in: | Annals of African medicine 2010-04, Vol.8 (4) |
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Main Authors: | , , |
Format: | Article |
Language: | English |
Subjects: | |
Online Access: | Get full text |
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Summary: | Background: Pain during childbirth is a well known cause of
dissatisfaction amongst women in labor. The use of epidural analgesia
in labor is becoming widespread due to its benefit in terms of pain
relief. Method: After approval of the local Ethics Committee on
Research and obtaining informed written consent, 50 American Society of
Anesthesiologists (ASA) class I-II consecutive multiparous women in
labor requesting pain relief were enrolled in this prospective study.
After providing description of the two options of pain relief available
to them, they were allocated into two groups according to their
request-to receive either parenteral opioid/sedative or epidural labor
analgesia. Both groups received analgesia of choice at 4-cm cervical os
dilatation. The epidural group received 0.125% plain bupivacaine, while
the other group received pentazocine/promethazine intravenously. The
time taken to locate the epidural space, catheter-related complications
encountered and the amount of intravenous fluid used were documented.
Result: The two groups were comparable in terms of socio-demographic
data. The mean duration of the first and second stages of labor,
respectively, were significantly shorter in the epidural group when
compared with those in the non-epidural group ([ P < 0.01] and [ P
< 0.02]). There was no difference in the rate of cesarean delivery
between them - epidural analgesia (32% [8/25]) versus parenteral
opioid/sedative (44% [11/25]), (OR, 0.60; 95% CI, 0.19-1.90). The
maternal blood loss from delivery was minimal, with no statistical
difference between the two groups ( P = 0.27). The neonatal outcome was
the same in both groups. Closed questionnaire showed that the overall
experience of labor was much better (it was also better than expected)
in the epidural group when compared with that in the non-epidural group
(80% versus 4%). Eighteen (72%) women had inadequate pain relief in the
non-epidural group as compared to 2 (8%) women in the epidural group.
Conclusion: The study shows that epidural labor analgesia is acceptable
to women in our setting. More women in the epidural analgesia group
were satisfied with the experience of labor than those who did not
receive this form of analgesia than among those who received parenteral
opioid/sedative. |
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ISSN: | 1596-3519 |