Epidural Versus Low-dose Spinal for Analgesia of Late First Stage of Labor

Epidural Versus Low-dose Spinal for Analgesia of Late First Stage of Labor: A Randomized Clinical Trial

The aim of this study is to compare the effect of epidural analgesia versus low-dose spinal analgesia in parturient in the late first stage of labor regarding time needed to perform the block, duration of the intra- and postoperative analgesia and incidence of procedure related adverse events.

Inclusion Criteria:

• Parturient with normal vaginal delivery in late first stage of labor (cervical dilatation ≥ 6 cm by examination)
• Aged 18-40 years old
• Single, term pregnant with normal fetal heart rate
• Request neuroaxial analgesia

Exclusion Criteria:

• Parturient who refuses to participate,
• American Society of Anesthesiologists (ASA) physical status >II,
• Body mass index more than 35 kg/m2
• Severe pre-eclampsia or eclampsia
• Uncontrolled thyrotoxicosis
• Cardiovascular troubles (e.g. stenotic valvular heart disease or cardiomyopathy)
• Increased intracranial tension due to a space-occupying lesion
• Any contraindication to regional anesthesia such as local skin or soft tissue infection, coagulopathy or receiving anticoagulant therapy, thrombocytopenic, uncorrected hypovolemia, preexisting neurologic deficits, spinal deformity or previous spine surgery.
• Hypersensitivity to the study drugs
• Parturient who scheduled for emergency cesarean section due to fetal distress, antepartum hemorrhage, multiple gestation or fetal malpresentation