A prospective study of comparison of analgesia and foetal outcome in term parturients with and without low dose combined spinal epidural labour analgesia

Abstract

Background: Ideally pain relief with epidural techniques should be produced with minimum disturbance to the progress of labour or to sympathetic functions, sensory functions (proprioception) and motor functions of the CNS. Materials and Methods: This study was undertaken after obtaining approval from the Research and Ethics committee of the hospital. Written informed consent was obtained from all parturients. This study did not interfere with the normal obstetric management technique employed in this hospital. This is a prospective case control study. The study population included 120 pregnant women 60 of who were given labour analgesia-‘GROUP T’ and 60 of who underwent a delivery without labour analgesia-‘GROUP C’. Studied patients were ASA physical status I and II parturients with term singleton gestations and cephalic presentation who requested analgesia. When the patient was in active labor, achieving a cervical dilation of 3-4cm and requested analgesia, a combined spinal-epidural technique was used. Parturients were excluded who were unwilling, any contraindication to regional technique, history of local anesthetic allergy, psychological or neurological diseases. Results: There were no differences between the groups with respect to demographic and labor characteristics. Gestational age. Height and weight, Parity, cervical dilatation at which analgesia was instituted, were compared and no significant difference was obtained (p>0.05). Though a higher mean systolic and diastolic BP, pulse rate were seen in stage 2 in both groups, the vitals were significantly lower in Group T in both stage 1 and 2 when compared to Group C. Conclusion: Low dose’ labour analgesia is a safe technique for painless labour with no harmful effects on the mother or baby and it does not significantly affect the obstetric outcome.