Korean J Anesthesiol.  2015 Jun;68(3):249-253. 10.4097/kjae.2015.68.3.249.

The degree of labor pain at the time of epidural analgesia in nulliparous women influences the obstetric outcome

• Woo JH
• Kim JH
• Lee GY
• Baik HJ
• Kim YJ
• Chung RK
• Yun DG
• Lim CH

• KMID: 2148689
• DOI: http://doi.org/10.4097/kjae.2015.68.3.249

Abstract

BACKGROUND
The increased pain at the latent phase can be associated with dysfunctional labor as well as increases in cesarean delivery frequency. We aimed to research the effect of the degree of pain at the time of epidural analgesia on the entire labor process including the mode of delivery.
METHODS
We performed epidural analgesia to 102 nulliparous women on patients' request. We divided the group into three based on NRS (numeric rating scale) at the moment of epidural analgesia; mild pain, NRS 1-4; moderate pain, NRS 5-7; severe pain, NRS 8-10. The primary outcome was the mode of delivery (normal labor or cesarean delivery).
RESULTS
There were significant differences in the mode of delivery among groups. Patients with severe labor pain had a significantly higher cesarean delivery compared to patients with moderate labor pain (P = 0.006). The duration of the first and second stage of labor, fetal heart rate, use of oxytocin and premature rupture of membranes had no differences in the three groups.
CONCLUSIONS
Our research showed that the degree of pain at the time of epidural analgesia request might influence the rate of cesarean delivery. Further research would be necessary for clarifying the mechanism that the augmentation of pain affects the mode of delivery.

Keyword

Epidural analgesia; Labor pain; Obstetric delivery

MeSH Terms

Analgesia, Epidural*
Delivery, Obstetric
Female
Heart Rate, Fetal
Humans
Labor Pain*
Membranes
Oxytocin
Pregnancy
Rupture
Oxytocin