THE EFFECT OF EARLY EPIDURAL BLOCK ADMINISTRATION ON THE PROGRESSION AND OUTCOME OF LABOR

This study was undertaken to prospectively evaluate the effect of earl y administration of epidural bupivacaine (0.25%) on the progression an d outcome of labor in 60 nulliparous patients. Patients were randomly divided into two groups. In group 1 (30 patients, early administration ), the epidural catheter was sited and the first epidural injection of 0.25% bupivacaine administered at a cervical dilatation of <4 cm; gro up 2 (30 patients, late administration) received the epidural catheter and first epidural injection of 0.25% bupivacaine at a cervical dilat ation of greater than or equal to 4 cm. The progression and outcome of labor were compared between the two groups. There were no statistical ly significant differences between the two groups in rate of cervical dilatation, duration of the second stage, numbers of instrumental deli veries or cesarean sections or Apgar scores at 1 and 5 min. We conclud e that there is no need to restrict epidural top-ups until cervical di latation of 4 cm, when active management of labor is advocated.