title: The effect of epidural analgesia on the second stage of labor.
abstract: A retrospective review of 202 randomly selected records of parturient labors examined the relationship between cervical dilation at epidural analgesia administration and length of the second stage of labor. The epidural group received bupivacaine 0.11% or 0.125% with sufentanil 1 to 2 micrograms/mL using a Bard Patient Controlled Anesthesia II pump. Labor management and outcomes were compared with a nonepidural group who chose unmedicated childbirth, intravenous narcotics, or pudendal block. A significant inverse correlation was found between cervical dilation at epidural administration and second-stage length in labors that did not use oxytocin. However, linear regression explained only 13.5% of the variance, leaving 86.5% unexplained. In labors in the epidural group that used oxytocin, cervical dilation at epidural administration was not correlated with second-stage length. The epidural group experienced a significantly longer mean length of the second stage. Labors in the epidural group were 3.5 times more likely to have oxytocin induction or augmentation and 4.5 times more likely to experience instrument-assisted delivery. There were no significant differences in Apgar scores between the two infant groups.
authors.affiliation: Uniformed Services University of the Health Science, Bethesda, Maryland, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: McRae-Bergeron
authors.forename: C M
authors.initials: CM
authors.lastname: Andrews
authors.forename: P J
authors.initials: PJ
authors.lastname: Lupe
mesh_terms: D000759:Adjuvants, Anesthesia / Q000627:therapeutic use*; D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D002584:Cervix Uteri / Q000187:drug effects*; D005260:Female; D006801:Humans; D007748:Labor Stage, Second / Q000187:drug effects*; D016014:Linear Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D017409:Sufentanil / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D017409:Sufentanil; D002045:Bupivacaine