OUR EXPERIENCE WITH EPIDURAL LABOUR ANALGESIA
Background. To evaluate the effects of regional labour analgesia used at the Hospital for Gynecology and Obstetrics in Postojna, Slovenia, in the year 2002.
Patients and methods. In this retrospective study we enrolled 294 parturients who delivered in the year 2002 in the Postojna Maternity Hospital: in group 1 there were 147 parturients in whom three different regional analgesic techniques (study group) were used at labour; in group 2 there were 147 parturients in whom regional analgesia was not used (control group). In the first step the two groups were compared in terms of maternal demographic data, duration and outcome of labour and 1' and 5' Apgar scores. In the second step the three regional analgesic groups were compared in terms of the course and outcome of labour, fetal condition, side and adverse effects of regional analgesic techniques, and patient satisfaction with a particular analgesic technique.
Results. Regional labour analgesia was used in 147 (14%) of the 1048 women who delivered in 2002: epidural analgesia (EPI) was performed in 51.0%, combined spinal-epidural (CSE) in 42.2% and spinal analgesia (SA) in 6.8% of cases. The women in the regional analgesia group were significantly older, more educated, more often nulliparous and accompanied by their partner at labour than the women in the control group. Further, the duration of labour was significantly longer, oxytocin more frequently administered than in the control group. In terms of labour outcome there were no differences in the Cesarean section rates and 1- and 5-min Apgar scores minutes, but and the vacuum extraction rate was significantly higher in the regional analgesia group. Among the three regional analgesia techniques used, there were no statistically significant differences observed in terms of labour duration and outcome, and Apgar scores. The patient satisfaction was greatest with CSE. Adverse side effects such as weak muscles, reduced motion abilities, itching, nausea, headache, a drop in blood pressure were not increased in none of the regional analgesia technique group.
Conclusions. Since regional analgesic techniques offer excellent labour pain relief with minimal adverse effects on labour outcome, it is reasonable to proceed using them in the future, as well as to thoroughly inform the parturient about this effective method of pain relief prior to labour.
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