Effects of epidural analgesia: some questions and answers.


Journal Article

The effects of epidural analgesia on first labors have been studied by Thorp and colleagues. One study has been published and is the subject of a question-and-answer discussion, presented here. In this study 711 consecutive nulliparous women at term, with spontaneous onset of labor and cephalic presentation, were divided into one group (n = 447) who received epidural analgesia in labor and another group (n = 264) who received narcotics or no analgesia. The frequency of cesarean section for dystocia was significantly greater (p less than 0.005) in the epidural group (10.3%) than in the nonepidural group (3.8%), even after selection bias was corrected and the variables of maternal age and race; gestational age; cervical dilatation on admission; use, duration, and maximum infusion rate of oxytocin; labor duration; presence of meconium; and birth weight were controlled. For both groups the frequency of cesarean section for fetal distress was similar (p less than 0.20), and the frequency of low Apgar scores at 5 minutes and cord blood gas values showed no significant differences. The authors concluded that "epidural analgesia in labor may increase the incidence of cesarean section for dystocia in nulliparous women".

Full Text

Duke Authors

Cited Authors

  • Thorp, JA; McNitt, JD; Leppert, PC

Published Date

  • September 1990

Published In

Volume / Issue

  • 17 / 3

Start / End Page

  • 157 - 162

PubMed ID

  • 2222642

Pubmed Central ID

  • 2222642

International Standard Serial Number (ISSN)

  • 0730-7659

Digital Object Identifier (DOI)

  • 10.1111/j.1523-536x.1990.tb00725.x


  • eng

Conference Location

  • United States