Register for Combining Epidural Analgesia with Opioids Decreases Cesarean Risk
Labor PainSeptember 28, 2000
(NewsRx.com) -- Administration of opioid pain relievers in addition to epidural local anesthesia for labor pain can decrease both the risk of operative delivery and the average post-delivery hospital stay, study results indicate.
H. Rydhstroem and colleagues in Sweden conducted a "population-based observational study...to evaluate the effect of adding an opioid to a local anesthetic drug on the risk of instrumental delivery or cesarean section" ("Epidural analgesia with sufentanil during labor and operative delivery," Acta Obstetricia Et Gynecologica Scandinavica, 2000;79(7):538-542).
The researchers used information from the Medical Birth Registry in Stockholm and from questionnaires sent to all 61 Swedish childbirth units to study the effectiveness of additional opioid administration on all 85,691 deliveries using epidural analgesia in Sweden from 1992 to 1996.
Women administered opioids in addition to epidural analgesia had significantly reduced rates of instrumental delivery, with an odds ratio of 0.72 and a 95% confidence interval (CI) of 0.68 to 0.76, compared to women who were given epidural local anesthetic alone, reported Rydhstroem et al.
Women giving birth for the first time also had a significantly lower risk of requiring a cesarean section under these circumstances, although women who had already borne children did not realize this benefit, according to the report.
In addition, opioid administration decreased the average post-delivery hospital stay, with fewer women given opioids with epidurals requiring postpartum hospital stays of four days or later, the researchers said.
"When added to the local anesthetic used for epidural analgesia, as in Sweden during the last five years, opioids appear to reduce the incidence of instrumental delivery and cesarean section and also the postpartum hospital stay," concluded Rydhstroem et al.
The corresponding author for this report is H. Rydhstroem, Cent Hosp, Dept. Obstet. & Gynaecol., SE-25187 Helsingborg, Sweden.
A search of the online archives at www.newsrx.com using the term "pregnancy" yielded 2,001 articles.
Key points reported in this study include:
* The addition of an opioid pain reliever to epidural local anesthesia for labor pain can decrease both the risk of operative delivery and the average post-delivery hospital stay
* Women given opioids in addition to epidural had significantly less chance of requiring instrumental delivery than women given only epidural analgesia, and women giving birth for the first time also had less chance of requiring a cesarean section
* Combining epidural analgesia with opioid administration decreased the average post-delivery hospital stay
This article was prepared by Women's Health Weekly editors from staff and other reports.
©Copyright 2000, via NewsRx.com
