A comparison of two epidural analgesic techniques with respect to the outcome of labour

SummaryA prospective controlled trial was undertaken to investigate the efficacy of continuous infusion epidural analgesia in labour compared to conventional 'topped-up' epidurals. There were 70 patients with continuous infusions and 79 in the 'topped-up' group. Clinical parameters and duration of labour did not differ between the groups. More patients having continuous infusions (49 per cent) delivered normally than in those who were topped-up (30 per cent, P < 005). The incidence of low cavity instrumental delivery was correspondingly higher in the 'topped-up' patients (65 versus 45 per cent). The incidence of obstetric intervention for maternal distress was higher (P < 0-001) in the 'topped-up' patients. There was no difference between the groups with regard to perinatal outcome although the infusion patients had a higher mean cord artery pH level. A reduced workload for the anaesthetist was confirmed with the infusion technique.