title: Lumbar epidural analgesia--the pursuit of perfection. With special reference to midwife participation.
abstract: Lumbar epidural block for the relief of pain in labour has been reported as having a variable frequency of success. Analysis of a personal series of 1544 epidurals carried out with the close co-operation of midwives shows that, with attention to details of management, satisfactory analgesia can be assured in well over 90% of all labours. Total failure should be a rare event and the causes of more than half the partial failures can be traced to errors of management.
mesh_terms: D000763:Anesthesia, Caudal; D000767:Anesthesia, Epidural / Q000451:nursing / Q000592:standards*; D000773:Anesthesia, Obstetrical / Q000451:nursing / Q000592:standards; D002045:Bupivacaine; D005260:Female; D006801:Humans; D007747:Labor Stage, First / Q000187:drug effects; D007748:Labor Stage, Second / Q000187:drug effects; D009721:Nurse Midwives; D010146:Pain / Q000188:drug therapy; D011187:Posture; D011247:Pregnancy; D013997:Time Factors; D014599:Uterus
chemical_list: D002045:Bupivacaine