Is second-stage labor longer with epidural analgesia?
Results of new research show that the duration of second-stage labor is no different with epidural analgesia versus a placebo. The findings, published in Obstetrics & Gynecology, are from a double-blind, randomized trial in nulliparous women with term cephalic singletons.
For the research, 400 women who had received 0.08% ropivacaine with 0.4 mcg/mL sufentanil during first-stage labor were randomized at the onset of second-stage labor to a blinded infusion of either the same epidural solution or a placebo saline infusion. The primary outcome was duration of second-stage labor and the trial was powered to identify at least a 15% difference in duration.
An intent-to-treat analysis showed that the duration of second-stage labor was similar between the two groups of women (52±27 minutes for epidural vs 51±25 minutes for saline; P = .52). Rates of spontaneous vaginal delivery also were similar (193 [96.5%] for epidural vs 198 [99%] for saline, P = .17). At each measurement during the second stage, pain scores were similar but more women in the placebo group reported satisfaction scores of 8 or less (saline 62 [30.5% vs epidural 32 [16%]; P = .001.
Their data, the authors said, demonstrate that maintaining an epidural infusion has no effect on the duration of second-stage labor compared with placebo.