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Continuing Education in Anaesthesia, Critical Care & Pain 2004 4(4):114-117; doi:10.1093/bjaceaccp/mkh030
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Continuing Education in Anaesthesia, Critical Care & Pain | Volume 4 Number 4 2004 © The Board of Management and Trustees of the British Journal of Anaesthesia 2004

Epidural analgesia in labour

Elizabeth McGrady, MB ChB FRCA, Consultant Anaesthetist
Directorate of Anaesthesia, Walton Building, Glasgow Royal Infirmary, Glasgow, G4 0SF

Kerry Litchfield, MB ChB FRCA, Clinical Research Fellow
University Department of Anaesthesia, 2nd floor Queen Elizabeth Building, 10 Alexandra Parade, Glasgow, G31 2ER
Tel: 01412 114620/1, Fax: 01412 114622, E-mail: elizabeth.mcgrady{at}northglasgow.scot.nhs.uk (for correspondence)

Since epidural analgesia was introduced four decades ago for pain relief in labour, controversy has persisted about its effect on the labour process. As a result of this, considerable research has been performed and findings have led to changes in practice. Epidurals have been credited with prolonging labour; increasing oxytocin requirements, instrumental and operative delivery rates; and causing maternal pyrexia and postpartum back pain. There is increasing evidence that refutes some of these claims.

Despite ongoing controversies, epidural rates have increased; ~25% of women in the UK and 66% of women in the USA receive epidural analgesia in labour. The following statement from the American College of Obstetricians and Gynecologists summarizes the background to these figures: ‘labour results in severe pain for many women. There is no other circumstance where it is considered acceptable for a person to experience untreated severe pain, amenable to safe intervention, while under a physician's care.’


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