Observations in the Postpartum Recovery Room after Various Local Anesthetic Techniques

Epidural analgesia with bupivacaine (0.5%) was compared with other techniques of pain relief for labor and/or delivery (subarachnoid block with 5% lidocaine in 7.5% dextrose in water, 1.5% mepivacaine or 1.5% lidocaine epidural, and pudendal block or local infiltration of the perineum) in a large series of patients unselected except to exclude parturients with multiple gestations, breech presentations, and those delivered by cesarean section. All patients receiving regional analgesia delivered spontaneously or by low forceps; all patients in the pudendal block/local infiltration group delivered spontaneously. Time from last dose of anesthetic until discharge from recovery room was shortest in the latter group. Motor block with spinal anesthesia diminished more rapidly than with the epidural agents, of which bupivacaine lasted longest. The incidence of shivering, headache, nausea, vomiting, hypertension or hypotension, and urinary bladder retention requiring catheterization is discussed.