Epidural Used Less When Woman Can Control
When given control over the amount of epidural anesthesia they receive during labor and delivery, women actually use 30 percent less and report the same satisfaction level than when they are given a standard dose from a doctor.
Researchers at the Long Beach Memorial Medical Center presented these findings yesterday at the meeting for the Society for Maternal-Fetal Medicine. “We looked at patient-controlled epidural anesthesia, and found the women were basically as comfortable as women on a continuous dose, and there was a 30 percent reduction in the amount of anesthesia used," said study author Dr. Michael Haydon”
For this study, the researchers divided 270 women who were going through labor and delivery of their first child into three different groups. The first group received a standard epidural anesthesia infusion which involves the insertion of a catheter into the epidural space of the spine. Pain medication is administered through the catheter by pump at a continuous rate throughout labor and delivery. The second group was given the continuous epidural infusion, but was also given a button they could push to administer extra doses of medication every 20 minutes if desired. The third group was not given the continuous infusion, but given only the button to receive doses every 20 minutes as desired.
Among all three groups of women they found that the women who had complete control over the amount of mediation they received by pushing the button actually consumed less overall medication than the other two groups who had continuous infusions. More importantly, however, was the finding that there was no difference in satisfaction rating of these women.
The researchers also noted that there was a slight decease in the amount of instrumental deliveries (delivery with use of a vacuum or forceps) in the group who only used the button. There was no difference in the incidences of cesarean delivery or total time of labor.
Although these findings are preliminary, this study may mark the beginning of the trend away from continuous epidural anesthesia infusions during labor and delivery.
“We'd like to move toward more individualized pain care for labor, possibly using an automated delivery system in response to patient needs. This study shows that using less anesthesia seems to be possible with this delivery system," Haydon said.
Epidural anesthesia is used by as many as 75 percent of women in the US during labor and delivery. This popular pain management option is considered safe, however it has been linked to increased risks for cesarean section, vacuum or forceps assisted delivery, and increased vaginal trauma.