Intensity of labor pain and cesarean delivery.
Some authors have suggested that the intensity of labor pain may be related to labor dystocia. We performed a secondary analysis of a previously published randomized investigation of the effects of epidural analgesia during labor compared with patient-controlled IV meperidine on cesarean delivery. Two-hundred-fifty-nine women who received patient-controlled IV meperidine were identified for analysis. All women were in spontaneous labor with a singleton, term gestation. Women requiring 50 mg or more of meperidine per hour during labor were compared with those who required <50 mg/h. In addition, their pain scores (visual analog scale) were compared before and after analgesia administration. Pain scores were significantly higher in women requiring 50 mg/h of meperidine (8.7 vs 8.0, P = 0.05), and their labors tended to be longer (9 vs 5 h, P = 0.09). More cesarean deliveries for obstructed labor were performed in women requiring >50 mg/h of meperidine (14% vs 1.4%, P = 0.001). Neonatal outcomes were similar in the two groups.
Alexander
J M
JM
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas 75235-9032, USA. jalexa@mednet.swmed.edu
Sharma
S K
SK
McIntire
D D
DD
Wiley
J
J
Leveno
K J
KJ
D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000701:Analgesics, Opioid; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D008614:Meperidine; D010147:Pain Measurement / Q000187:drug effects*; D011247:Pregnancy; D011256:Pregnancy Outcome
D000701:Analgesics, Opioid; D008614:Meperidine