Early versus late initiation of epidural analgesia for labour

Abstract

There is predominantly high-quality evidence that early or late initiation of epidural analgesia for labour have similar effects on all measured outcomes. However, various forms of alternative pain relief were given to women who were allocated to delayed epidurals to cover that period of delay, so that is it hard to assess the outcomes clearly. We conclude that for first time mothers in labour who request epidurals for pain relief, it would appear that the time to initiate epidural analgesia is dependent upon women's requests.

Predictive Factors for Cesarean Delivery ? A Retrospective Study

“…Mode of labor epidural analgesia, as well as the moment in labor stage when it has begun (assessed as cervix dilatation) does not seem to influence type of delivery in our sample, data consistent with the most recent discussions on the subject [27].…”

“…Data from observational studies have suggested an association between cesarean delivery and the initiation of neuraxial analgesia during early labor (usually defined as cervical dilation less than 4-5 cm) [23,24]. However, meta-analysis of the literature determined that the timing of neuraxial analgesia does not affect the frequency of cesarean delivery [25,27].…”

Perinatal outcome of vaginal delivery with epidural analgesia initiated at the early or late phase of labor period: A retrospective cohort study in the Japanese population

“…Reports from other countries have shown that obstetrical outcomes do not differ markedly between the early and late initiation of epidural analgesia after labor has started . However, those data were based on non‐Japanese populations, and whether or not the perinatal outcomes between early and late initiation of epidural analgesia during labor would share the same relationship in a Japanese population was unclear.…”

Can oxytocin augmentation modify the risk of epidural analgesia by maternal age in cesarean sections?

“…However, administering epidural analgesia as part of routine, compared to administration on request, has been found to increase the probability of a cesarean section 174 . The timing of the epidural, i.e., early or late in the first stage of labor, has not been found to influence the risk of cesarean section 175 .…”