Epidural Analgesia in High Risk Patients During Labour.

ABSTRACT

In this prospective observational study, 28 high risk patients were analyzed after giving epidural analgesia (EA) for labor pain relief over a period of 3 years. 5 cc Bupivacaine (0.125%) + 1 cc Fentanyl (10 mcg) were given and the maternal pain relief and fetal outcome were analyzed. Onset time of analgesia and level of analgesia was assessed by pin prick method.21 patients were primigravidae. 15 patients had a single risk factor while 13 patients had 2 risk factors affecting simultaneously. Pregnancy Induced Hypertension (PIH) was the commonest high risk condition occurring in 20 patients. Average analgesia onset time was 7.8 minutes. Analgesia lasted for > 2 hrs after administration of first dose in 23 patients. Rate of LSCS was 7.1% (2 patients) and instrumental delivery was 14.2 % (4 patients). 24 babies had an Apgar score of >/= 7. Complete pain relief was observed in 10 patients while 16 had moderate, 1 had slight and 1 had no pain relief. No major maternal or fetal complications were reported. EA is a very safe and effective form of analgesia in the interest of maternal and fetal welfare not only in normal pregnant gravidas, but also in high risk patients.