Effect of epidural analgesia on cesarean section in nulliparous women

Kang, Yong In; Kim, Byeong Kuk; Bang, Eun Chi; Kim, Su Yeon; Lee, Hyun Sook; Cho, Kyoung Sook

Clinical Research

Obstetric Anesthesia

Anesthesia and Pain Medicine 2010;5(1):75-78.
Published online January 30, 2010.

Effect of epidural analgesia on cesarean section in nulliparous women

Yong In Kang, Byeong Kuk Kim, Eun Chi Bang, Su Yeon Kim, Hyun Sook Lee, Kyoung Sook Cho

Department of Anesthesiology and Pain Medicine, College of Medicine, CHA University, Seoul, Korea. anein09@naver.co.kr

Abstract

BACKGROUND
The effect of epidural analgesia for labor on obstetric outcome is controversial. The purpose of this study is evaluating the influence of epidural analgesia on cesarean section in nulliparous women.
METHODS
We retrospectively investigated 979 nulliparous women ASA graded I - II. EPI (n = 230) was received epidural analgesia with 0.2% ropivacaine and 75microgram fentanyl. N-EPI (n = 749) was received no epidural analgesia but nalbuphine 10 mg intramuscularly. We compared the rate and causes of cesarean section, instrumental delivery rate and fetal outcomes between EPI and N-EPI.
RESULTS
Cesarean section rate was not different between the EPI (18%) and N-EPI (23%). Causes of cesarean section were progress failure (83% in EPI and 80% in N-EPI) and fetal distress (17% in EPI and 20% in N-EPI) and there were no differences between two groups. Instrumental delivery rate was higher in EPI (8%) than N-EPI (5%). Fetal outcome was not different between two groups.
CONCLUSIONS
Epidural analgesia did not increase cesarean section rate and did not influence on causes of cesarean section. But epidural analgesia increased the vacuum delivery rate.

Key Words: Cesarean section, Epidural analgesia