Effects of Epidural Anesthesia on Labor Progress
Although delivery is a normal physiologic process, it causes a certain level of pain in women. Today, the most frequently preferred and the most used method is epidural anesthesia. The objective of the present study was to review the reasons, effects, and risks associated with epidural analgesia for pain relief. The study was conducted at Akdeniz University Hospital, Antalya, Turkey, between October 2004 and July 2005. Epidural analgesia was administered to 51 pregnant women in the experimental group, and 51 pregnant women in the control group did not receive analgesia. Data were collected by questionnaire and observation forms. Epidural anesthesia was chosen by 76.5% of the participants because they wanted to experience a pain-free childbirth, 66.7% because they were afraid of the process of delivery, 25.5% because they had had a previous bad labor experience, 35.3% because they had people around them with positive experiences, 29.4% because they wanted to have a normal delivery, and 31.4% because they wanted first to see their baby. The overwhelming majority of the participants (94.1%) experienced nervousness before the administration of epidural analgesia. It was determined that epidural analgesia extended the time of labor and increased oxygen and oxytocin requirement but did not increase the risk for interventional delivery and cesarean. To give better obstetric care and control of labor pain, it is of clinical importance to know obstetric anesthesia and analgesics.
Labor pain is known and defined as one of the most severe varieties of pain. As a result, an appropriate pain management plan is important both for a successful delivery and to decrease pain as much as possible (Poole, 2003). A variety of anesthesia methods for delivery are used in different regions of the world. Epidural anesthesia is the most frequently used method of pain control. It is reliable and is the preferred method of anesthesia for over 50% of hospitalized women in developed countries (Balcioglu, 2004; Camann, 2005; Essam & Arulkumaran, 2005 Lieberman 2004, Robert and Gaiser 2005). Today, the use of epidural analgesia is rapidly on the rise globally. Reasons for this increase include the decreased risk of morbidity, developments in epidural techniques, and women's pain-free delivery experiences (Robert and Gaiser 2005, Vincent and Chestnuta 1998).
Epidural labor analgesia can have positive effects, such as a decrease in mothers' stress as a result of labor pain relief, balancing of respiratory rate and amplitude, lack of disturbance in maternal and fetal acid base balance and uteroplacental circulation, and decrease in blood pressure in preeclampsia. In addition to these physiologic benefits, epidural labor analgesia also provides patients with psychologic comfort and alleviation of excessive pain and ensures that they leave the hospital more satisfied (Bofill et al., 1997).
In contrast, Mayberry et al. (2002) found that epidural anesthesia causes maternal exhaustion, which in turn causes the pelvic floor to be damaged and an increase in the incidence of cesarean. Other side effects of epidural analgesia may be cited, such as maternal hypotension, itching, shivering, fever, urinary retention, and dural puncture (Leighton and Halpern 2002a, Lieberman 2004, Mayberry et al 2002).
Although epidural analgesia is becoming increasingly popular around the world, its application in Turkey is still restricted. Therefore, the purpose of the present study was to examine the reasons why women prefer epidural analgesia and the level of participants' knowledge concerning epidural analgesia. We also examined the effects of epidural analgesia on both the mother and the baby.
Although delivery is a normal physiologic process, it causes a certain level of pain in women. Today, the most frequently preferred and the most used method is epidural anesthesia. The objective of the present study was to review the reasons, effects, and risks associated with epidural analgesia for pain relief. The study was conducted at Akdeniz University Hospital, Antalya, Turkey, between October 2004 and July 2005. Epidural analgesia was administered to 51 pregnant women in the experimental group, and 51 pregnant women in the control group did not receive analgesia. Data were collected by questionnaire and observation forms. Epidural anesthesia was chosen by 76.5% of the participants because they wanted to experience a pain-free childbirth, 66.7% because they were afraid of the process of delivery, 25.5% because they had had a previous bad labor experience, 35.3% because they had people around them with positive experiences, 29.4% because they wanted to have a normal delivery, and 31.4% because they wanted first to see their baby. The overwhelming majority of the participants (94.1%) experienced nervousness before the administration of epidural analgesia. It was determined that epidural analgesia extended the time of labor and increased oxygen and oxytocin requirement but did not increase the risk for interventional delivery and cesarean. To give better obstetric care and control of labor pain, it is of clinical importance to know obstetric anesthesia and analgesics.
Labor pain is known and defined as one of the most severe varieties of pain. As a result, an appropriate pain management plan is important both for a successful delivery and to decrease pain as much as possible (Poole, 2003). A variety of anesthesia methods for delivery are used in different regions of the world. Epidural anesthesia is the most frequently used method of pain control. It is reliable and is the preferred method of anesthesia for over 50% of hospitalized women in developed countries (Balcioglu, 2004; Camann, 2005; Essam & Arulkumaran, 2005 Lieberman 2004, Robert and Gaiser 2005). Today, the use of epidural analgesia is rapidly on the rise globally. Reasons for this increase include the decreased risk of morbidity, developments in epidural techniques, and women's pain-free delivery experiences (Robert and Gaiser 2005, Vincent and Chestnuta 1998).
Epidural labor analgesia can have positive effects, such as a decrease in mothers' stress as a result of labor pain relief, balancing of respiratory rate and amplitude, lack of disturbance in maternal and fetal acid base balance and uteroplacental circulation, and decrease in blood pressure in preeclampsia. In addition to these physiologic benefits, epidural labor analgesia also provides patients with psychologic comfort and alleviation of excessive pain and ensures that they leave the hospital more satisfied (Bofill et al., 1997).
In contrast, Mayberry et al. (2002) found that epidural anesthesia causes maternal exhaustion, which in turn causes the pelvic floor to be damaged and an increase in the incidence of cesarean. Other side effects of epidural analgesia may be cited, such as maternal hypotension, itching, shivering, fever, urinary retention, and dural puncture (Leighton and Halpern 2002a, Lieberman 2004, Mayberry et al 2002).
Although epidural analgesia is becoming increasingly popular around the world, its application in Turkey is still restricted. Therefore, the purpose of the present study was to examine the reasons why women prefer epidural analgesia and the level of participants' knowledge concerning epidural analgesia. We also examined the effects of epidural analgesia on both the mother and the baby.
Source...