EPIDURAL ANALGESIA DURING LABOR

Epidural analgesia is a commonly employed technique of providing pain relief during labor. The number of parturients given intrapartum epidu ral analgesia is reported to be over 50 percent at many institutions i n the United States. The procedure has few contraindications the prima ry ones being patient refusal, maternal hemorrhage and coagulopathy. I nduction of epidural analgesia in early labor remains controversial. H owever, many physicians induce analgesia as soon as the diagnosis of a ctive labor has been established and the patient has requested pain re lief: The most common complications occurring with epidural analgesia are maternal hypotension and postdural puncture headache. Retrospectiv e studies have demonstrated an association between epidural analgesia and increases in duration of labor, instrumental vaginal delivery and cesarean section far labor However, several recent prospective studies have concluded that epidural analgesia does not adversely affect the progress of labor or increase the rate of cesarean section. These rema in controversial issues among practicing physicians.