A Study to Assess the Effects of Epidural Analgesia and Parenteral Analgesia on Maternal and Neonatal Outcomes Among Parturients Experiencing Slow Progression of Labour: A Comparative Study
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Date
2024-06
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Publisher
Ibn Sina Academy of Medieval Medicine & Sciences
Abstract
Introduction: Epidural analgesia however has been shown to be associated with maternal side effects like hypotension, hyperthermia and prolonged labour which are likely to have adverse effects on the fetal outcome, thus discouraging its use in clinical practice. Neonatal/fetal effect should be one of the most important determinants for choosing ideal analgesia. As there is no study which specifically has looked into the effects of labour analgesia on neonatal outcomes on augmentation of labour, it would be prudent to measure the impact of epidural analgesia in parturients requiring augmentation of labour and its effects on maternal and neonatal outcomes. Materials and Methods: The present study was carried among 60 labouring women with partographic evidence of slow progress of labour requiring augmentation in active phase of labour. The enrolled women were randomly allocated into group 1 in which epidural analgesia was established according to guidelines of department of Anesthesia and intensive care, PGIMER. Patients in group 2 received IM tramadol hydrochloride 1 mg/kg (with max. dose 400 mg / 24 hours) every 4 hours. All the women were monitored for 24 to 48 hours postpartum period for complication like hypotension, motor weakness, urinary retention, sedation, nausea or vomiting, allergy fever. The neonates were followed up till discharge from hospital. Results: Most common maternal complication in epidural group was numbness and in tramadol group was vomiting. All most all (93%) of women in epidural group were satisfied with type of analgesia and more than 77% of women reported it to be excellent. In tramadol group only 41% reported analgesia as fair and good but rest of them were dissatisfied with type of analgesia (p-0.001). Ninety three percent of women in epidural group desired to use it again in next pregnancy as compared to 20% in tramadol group. Urinary retention needing catheterization was similar in both groups. Most of neonates in both the groups had established breast feeding with in 12hrs. There was no difference between the groups in the incidence of neonatal jaundice requiring phototherapy. No neonates in either group required NICU or nursery care. Conclusion: To conclude, our study results suggest epidural analgesia might have edge over narcotic analgesics in dystocia. Neonates are more likely to get benefit. However epidural analgesia might increase second stage complications and vigilant care whenever mother on epidural analgesia is mandatory.
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Keywords
Dystocia, Epidural Analgesia, Tramadol Hydrochloride
Citation
Rajak Brijmohan Kumar, Rajak Indra Jeet Kumar, Pandit Raj Kishor, Singh Ruby, Mandal Abhay, Pajiyar Ajay Kumar . A Study to Assess the Effects of Epidural Analgesia and Parenteral Analgesia on Maternal and Neonatal Outcomes Among Parturients Experiencing Slow Progression of Labour: A Comparative Study. International Journal of Medical Research Professionals. 2024 May; 10(3): 7-12