The influence of continuous epidural bupivacaine analgesia on the second stage of labor and method of delivery in nulliparous women

Anesthesiology. 1987 Jun;66(6):774-80. doi: 10.1097/00000542-198706000-00011.

Abstract

A randomized, double blind, placebo-controlled study was performed to evaluate the analgesic efficacy and influence of continuing an epidural infusion of 0.125% bupivacaine beyond a cervical dilatation of 8 cm in nulliparous women. When the cervix was greater than or equal to 8 cm dilated, coded study solution was substituted for the known 0.125% bupivacaine solution. The study solution for 46 patients was 0.125% bupivacaine; 46 patients received saline. During the first stage of labor, 44 (96%) women in the bupivacaine group, and 45 (98%) in the saline group, had analgesia of excellent or good quality. During the second stage, 36 (82%) women in the bupivacaine group, versus 18 (41%) women in the saline group, had analgesia of excellent or good quality (P less than .0001). Six (13%) women in each group underwent cesarean delivery after the start of the study solution. Among the women who delivered vaginally, the mean (+/- S.D.) duration of the second stage of labor was 124 (+/- 70) min in the bupivacaine group, versus 94 (+/- 54) min in the saline group (P less than .05). Twenty-one of 40 (53%) women in the bupivacaine group, versus 11 of 40 (28%) in the saline group, underwent instrumental vaginal delivery (P less than .05). Twenty-eight of 40 (70%) women in the bupivacaine group, versus six of 40 (15%) in the saline group; had surgical perineal anesthesia for vaginal delivery (P less than .0001). There were no significant differences between groups in Apgar scores or umbilical cord blood acid-base values.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesia / methods*
  • Anesthesia, Epidural*
  • Anesthesia, Obstetrical*
  • Bupivacaine*
  • Clinical Trials as Topic
  • Delivery, Obstetric / methods*
  • Double-Blind Method
  • Female
  • Humans
  • Labor Stage, Second / drug effects*
  • Labor, Obstetric / drug effects*
  • Parity
  • Pregnancy
  • Random Allocation

Substances

  • Bupivacaine