EFFECTS OF EPIDURAL ANALGESI A WITH LOW-DOSE BUPIVACAINE AND FENTANYL ON THE PROGRESS OF LABOR AND MODE OF DELIVERY

Epidural analgesia (EA) has been used to relieve labor pain in many obstetric units, yet controversy persists about its effect on progress and outcome in labor. The purpose of the current study was to evaluate the effect of EA on the rate of cervical dilation and myometrial contractility. In a 6-month period, 36 women who received standardized EA were matched with the next two delivering women of72 patients of the same parity who did not receive EA. The outcome variables were uterine activity, rate of cervical dilation, oxytocin therapy, and operative deliveries. Intermittent EA with bupivacaine and fentanyl did not result in a change in myometrial contractility and the rate of cervical dilation. Oxytocin therapy was significantly higher in the epidural group than in the nonepidural group (p<0.002). Operative deliveries were not more common in those without it (p>0.0S). After intermittent low-dose bupivacaine and fentanyl EA, myometrial contractility and the ability of the uterus to dilate the cervix are maintained with oxytocin. Despite prolongation of the second stage of labor, cesarean delivery was not common in the epidural group.