Effects of Epidural Analgesia on Labor Pain and Course of Labor in Primigravid Parturients: A Prospective Non-randomized Comparative Study
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BACKGROUND AND AIM: The aim of this study was to compare the effects of epidural analgesia on relief of labor pain, progress, and outcome of labor in primigravid parturients to those who did not receive any analgesia. METHODS: This was a hospital-based, quasi-experimental study conducted on 70 primigravid parturients at term with a single fetus in a cephalic presentation in active labor. Parturients who were willing to receive epidural analgesia formed group S (n=35) and parturients who refused epidural analgesia formed group C (n=35). The primary objective was to compare alleviation of pain measured by the Visual Analogue Scale (VAS) score. Secondary objectives were to compare the duration of labor, mode of delivery, and neonatal outcome. RESULTS: Pain intensity was significantly lower in group S compared to group C at all measured points of time (p<0.001). There was a quick fall in mean VAS score in group S from 7.94 to 3.86 within 20 min with the bolus dose, it further dropped to 1.03 after 3 h. Further, 88.6% of parturients in groups rated their pain relief as excellent and good satisfaction score. Prolongation of active phase of the first stage of labor (>6 h) was not significant (17.1 % in epidural group versus 5.7% in control group; p=0.259). However, prolongation of the second stage of labor (> 2h) was significant (18.2% in study group versus 0% in control group; p=0.024). The rate of cesarean section, instrumental vaginal delivery, and neonatal outcome was similar in both groups. No adverse effects were observed on maternal vitals, fetal heart rate and Apgar score at 5 min. CONCLUSION: Epidural analgesia alleviated labor pain in all primigravid parturients who opted for it, without an increase in cesarean section and instrumental vaginal birth. Improved parturients' satisfaction with associated neonatal safety provides a positive birth experience. There was no effect on duration of active phase of the first stage of labor, but the duration of the second stage of labor was slightly prolonged.
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Epidural analgesia is associated with substantial reductions in labor pain, improved maternal satisfaction, and attenuation of maternal and neonatal physiologic stress responses associated with childbirth.
“Epidural analgesia is the most common neuraxial modality and is associated with substantial reductions in labor pain, improved maternal satisfaction, and attenuation of maternal and neonatal physiologic stress responses associated with childbirth.3,21,22”
From Influence of Neuraxial Anesthesia Technique During Vaginal and Cesarean Delivery and Association with Postpartum Depression: A Narrative Review of Literature (2026) · cites this paper as [22]
The Discussion (page unavailable) reports significantly lower pain scores and high satisfaction with epidural analgesia. It does not establish attenuation of maternal and neonatal physiologic stress responses: it reports no effect on maternal vital signs and no significant difference in five-minute neonatal Apgar scores. (LLM, conf=0.88)
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Cites
The validation of the visual analogue scale for patient satisfaction after total hip arthroplasty
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Fagan, J., Dufour, S., Duet, S., Downs, E., Siddaiah, H., Viswanath, O., Shekoohi, S., & Kaye, A. (2026) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s579920
- Authors
- Deepak, D., Kumari, A., Mohanty, R., Prakash, J., Kumar, T., & Priye, S.
- Affiliations
- Rajendra Institute of Medical Sciences (IN)
- Corresponding author
- Kumari, Archana
- Venue
- Cureus
- Published
- 2022-06-19
- Volume
- 14
- Issue
- 6
- Pages
- e26090-e26090
- ISSN
- 2168-8184 (ISSN-L)
- PMC
- PMC9295827
- OpenAlex
- W4283118194
- Cited by
- 15
- References
- 1
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 9 · 2023: 1
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Cureus (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- epidural analgesia, labor pain, primigravida, duration of labor, second stage of labor, mode of delivery, cesarean section, instrumental delivery, neonatal outcomes, patient satisfaction
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