title: A prospective review of the labor analgesia programme in a teaching hospital.
abstract: BACKGROUND
  The structured labor analgesia programme in our tertiary care hospital has been in place for the past few years. We undertook this study to analyze the programme and to draw conclusions to further improve the outcomes.
  
  
  METHODS
  A prospective analysis of the data pertaining to 200 patients participating in an ongoing labor analgesia programme in a tertiary care hospital from Nov 2008 to Aug 2009 was performed.
  
  
  RESULTS
  Mean visual analog score (VAS) before epidural block was 8.34 ± 0.79. Post procedure the average VAS score was 2.20 ± 0.79. One hundred and fifty six (78%) parturients delivered vaginally, 18 (9%) required instrumentation with vacuum including 1 forceps delivery in a multiparous parturient. In 17parturients (8.7%) fetal distress led to a decision to perform LSCS for delivery. Multiparous patients were significantly more satisfied as compared to nulliparous patients (p = 0.010).
  
  
  CONCLUSIONS
  The study demonstrated excellent pain relief and patient satisfaction with minimal complications. The safety and efficacy of epidural bupivacaine in concentrations less than 0.625% combined with 25 mcg of fentanyl demonstrated in our study should be considered are commendation for the widespread adoption of the procedure in tertiary care hospitals.
authors.affiliation: Graded Specialist (Anaesthesia), MH Kirkee, Pune, India.
authors.forename: Indranil
authors.initials: I
authors.lastname: Sikdar
authors.affiliation: Associate Professor, Department of Anaesthesiology & Critical Care, Armed Forces Medical College, Pune 40, India.
authors.forename: Shivinder
authors.initials: S
authors.lastname: Singh
authors.affiliation: Senior Advisor (Anaesthesiology & Critical Care), Army Hospital (R&R), Delhi Cantt 10, India.
authors.forename: Rangraj
authors.initials: R
authors.lastname: Setlur
authors.affiliation: Professor & Head (Anaesthesiology), MS Ramaiah Medical College, Bengaluru, India.
authors.forename: C V R
authors.initials: CV
authors.lastname: Mohan
authors.affiliation: Senior Advisor (Anaesthesiology & Critical Care), Army Hospital (R&R), Delhi Cantt 10, India.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Datta
authors.affiliation: Lecturer in Biostatistics & Demography, Dept of Community Medicine, Armed Forces Medical College, Pune 40, India.
authors.forename: S R
authors.initials: SR
authors.lastname: Patrikar
keywords: Epidural; Labor Analgesia; Pain relief