Impact of walking epidural analgesia on obstetric outcome of nulliparous women in spontaneous labour.
BACKGROUND
To explore the effects of walking epidural analgesia on obstetric and neonatal outcomes, we performed a case-control study.


METHODS
Each nulliparous woman receiving walking epidural analgesia using 0.0625% bupivacaine (n = 44) was matched to two nulliparous historical controls receiving 0.125% or 0.25% bupivacaine (n = 88 each) for epidural analgesia while recumbent.


RESULTS
Maternal and obstetric parameters, fetal status and presentation, and oxytocin use were comparable among groups. Those receiving walking epidural analgesia walked for a mean of 60 min (range: 20-75 min). In the control groups the mean total durations of labour were shorter (58 min in the 0.125% group and 99 min in the 0.25% group, P < 0.05). Significantly fewer walking epidural analgesia cases than controls required instrumental vaginal delivery (P < 0.05). No other differences in obstetric or fetal outcome were observed and no mother fell or stumbled while walking.


CONCLUSIONS
Although it was associated with a prolonged first stage of labour, walking epidural analgesia appeared safe for nulliparous women and their babies.
de la Chapelle
A
A
Department of Anaesthesiology, University Hospital Nice, France. raymond.v@chu-nice.fr
Carles
M
M
Gleize
V
V
Dellamonica
J
J
Lallia
A
A
Bongain
A
A
Raucoules-Aimé
M
M
D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000779:Anesthetics, Local; D002045:Bupivacaine; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007747:Labor Stage, First; D010120:Oxytocics / Q000627:therapeutic use; D010121:Oxytocin / Q000627:therapeutic use; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D016138:Walking / Q000502:physiology*
D000779:Anesthetics, Local; D010120:Oxytocics; D010121:Oxytocin; D002045:Bupivacaine