Kausar Tasneem Bangash, Ghazala Mahmud, Aalia Jadaan, Shoaib Haider.
Mode of Delivery and Duration of Second stage in Laboring Women after Low Concentration epidural Infusions Versus Parenteral Opioid Aanalgesia.
Ann Pak Inst Med Sci Jan ;8(1):66-9.

Objective: To compare the effects of low concentration epidural infusions of bupivacaine with parenteral opioid analgesia on mode of delivery and duration of second stage in laboring women. Study Design: Quasi Experimental Study. Place and Duration: Labour room Department Obstetrics and Gynecology, Mother and Child Health Care Unit 1.Pakistan Institute of Medical Sciences (PIMS), Islamabad. Materials and Methods: The study included all laboring women in whom effect of epidural and parenteral analgesia on mode of delivery and duration of second stage of labour were recorded. The outcome of labour was assessed as duration of second stage of labour and mode of delivery in terms of spontaneous vaginal delivery, instrumental delivery or caesarian section. Results: In Epidural Bupivacaine group there were 30 (44%) instrumental deliveries, 34 (50%) normal vaginal deliveries and 4 (6%) had cesarean section. In Parenteral Pentazocine group 16 (23.52%) patients had instrumental and rest 52 (76.27%) had normal vaginal delivery. There was significant (P-value < 0.05) difference in both groups with respect to mode of delivery i.e. 52 (76.27%) patients in Parenteral Pentazocine group and 34 (50%) patients in Epidural Bupivacaine group. The comparison of duration of 2nd stage of labor in both groups showed that the mean duration of 2nd stage of labor in Epidural Bupivacaine group was significantly higher (75.19±8.10 vs. 37.40±0.61, P-value <0.05) as compared with Parenteral Pentazocine group. Conclusions: Epidural analgesia using low concentration infusions of bupivacaine is unlikely to increase the risk of caesarean section but may increase the risk of instrumental vaginal delivery, as well as prolongs the second stage of labour, as compared to parenteral opioid analgesia group.

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