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Routine Labor Epidural Analgesia Versus Labor Analgesia on Request: A Randomized Noninferiority Trial

Wassen, M.M.; Smits, L.J.; Scheepers, H.C.; Marcus, M.A.; Van Neer, J.; Nijhuis, J.G.; Roumen, F.J.

Obstetric Anesthesia Digest: March 2016 - Volume 36 - Issue 1 - p 48
doi: 10.1097/01.aoa.0000479528.49651.2b
Anesthesia and Analgesia: Regional Analgesia
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(BJOG. 2015;122(3):344–50)

Epidural analgesia (EA) offers the most effective pain relief during labor, but it is also associated with some adverse effects. Specifically, labor EA is associated with an increased risk of instrumental vaginal delivery (IVD), although not with an increased risk of cesarean section (CS). However, given that there is a correlation between women who have a strong need for pain relief and failure of progress in labor, it is not clear whether this increase in IVD is actually caused by EA or is merely a confounder in patients with abnormal labor.

Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, GROW-School for Oncology and Developmental Biology, Maastricht, The Netherlands

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