title: Walking Epidural : An Effective Method of Labour Pain Relief.
abstract: BACKGROUND
  Labour pain can be deleterious for mother and baby. Epidural analgesia relieves labour pains effectively with minimal maternal and foetal side effects. A prospective open label study was undertaken to ascertain effective dosing regime for walking epidural in labour.
  
  
  METHODS
  Fifty women with singleton foetus in vertex position were included. Epidural catheter was inserted in L2-3 / L3-4 interspinous space. Initial bolus of 10 ml (0.1% bupivacaine and 0.0002% fentanyl) solution was injected and after the efficacy of block was established, an epidural infusion of the same drug solution was started at the rate of 5 ml/hour.
  
  
  RESULTS
  In first stage of labour 80% of the parturient had excellent to good pain relief (visual analogue scale 1 to 3) with standard protocol while 20% parturient required one or more additional boluses. For the second stage, pain relief was good to fair (VAS 4-6) for most of the parturient. The incidence of caesarian section was 4% and 6% needed assisted delivery. No major side effects were observed.
  
  
  CONCLUSIONS
  0.1% bupivacaine with 0.0002% fentanyl maximizes labour pain relief and minimizes side effects.
authors.affiliation: Readers, Dept of Anaesthesiology & Critical Care, AFMC, Pune-411040.
authors.forename: R M
authors.initials: RM
authors.lastname: Sharma
authors.affiliation: Readers, Dept of Anaesthesiology & Critical Care, AFMC, Pune-411040.
authors.forename: R
authors.initials: R
authors.lastname: Setlur
authors.affiliation: Chief (Anaesthesiology), Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi-110085.
authors.forename: A K
authors.initials: AK
authors.lastname: Bhargava
authors.affiliation: Reader, Dept of Obstetrics & Gynaecology, AFMC, Pune-411040.
authors.forename: S
authors.initials: S
authors.lastname: Vardhan
keywords: Labour analgesia; Walking epidural