TO STUDY THE LABOUR AND PERINATAL OUTCOME OF EPIDURAL ANALGESIA IN ACTIVE PHASE OF LABOUR
Authors: Chauhan Isha , Thakur Sita , Chauhan Supriya 
Published: July 2023

Introduction: The delivery of an infant into the arms of a conscious and pain free mother is one of the most exciting and rewarding moments in life of a woman1. Analgesia during labour is a basic component of a relaxed childbirth experience and can inuence subsequent pregnancy desire4. Numerous strategies both pharmacologic and non pharmacologic, have been used as treatment of labour pain7. Regional analgesia remains the gold standard of pain relief during labour. It includes epidural analgesia, combined spinal epidural, and spinal analgesia. Epidural analgesia is a central nerve blockade technique which involves the injection of a local anaesthetic into the lower region of the spine. The injected agent gradually diffuses across the dura into the subarachnoid space. Blocking of the painful impulses becomes apparent within 10-20 minutes of administration13. However despite being so popular, epidural analgesia is not without complications, with hypotension being the most common. Other complications include accidental dural puncture, infection, intravascular placement, high block, postpartum backache and epidural hematoma. The advantages of epidural analgesia in labour are numerous but in our country this option is not widely available to the parturients. In the view of above, we plan to conduct a study in our set up to provide pain free delivery to parturients and to see the effect of epidural analgesia on labour and perinatal outcome. Aims And Objectives: To study labour and perinatal outcome of epidural analgesia in active phase of labour. Materials And Methods: A prospective interventional study was conducted in the Department of Obstetrics and Gynaecology in collaboration with Department of Anaesthesiology at Dr.RPGMC Kangra at Tanda after the approval of protocol review committee and ethical committee of the institution. Parturients reporting to labour room in early active phase of labour fullling the inclusion criteria were explained about the study and counselling regarding epidural analgesia was done. Those who were willing to participate in the study formed Group 1/Epidural group after taking informed written consent and Group 2/Non epidural group included women immediately next to epidural case with similar demographic characteristics who did not want epidural analgesia. These women received pain relief as per the standard protocol of our institution. Results: The two groups were similar with respect to demographic prole. There was no signicant difference in age, socioeconomic status, BMI between the two groups. There was no statistical signicant difference in the mode of onset of labour in both the groups (p value=0.297). Percentage of women who needed augmentation of labour was signicantly higher in group 1 as compared to group 2 (p value=0.002). There was no statistical difference in the mode of delivery in the two groups. There was no statistical signicant difference in duration of rst stage of labour (p value=0.551) as well as in duration of second stage of labour (p value=0.45) in both the groups. The mean VAS score after administration of epidural analgesia at 15 minutes as well as during second stage of labour was signicantly higher in Group 2 as compared to Group 1 (p value<0.0001). Conclusion: From the present study it was observed that women with epidural analgesia during labour had signicant pain relief as compared to women who were given conventional pain relief as per the institutional protocol. There was no prolongation of rst and second stage of labour in the epidural group compared with control group, though more augmentation of labour with oxytocin was required in the epidural group. Also no signicant increase in the incidence of operative vaginal delivery or caesarean section was observed due to epidural analgesia.