The provision of epidural analgesia during labour at the University Hospital, Jamaica April 1979 - January 1980 - abstract

ABSTRACT

Pain relief on the labour ward at the University Hospital of the West Indies is afforded mainly by the parenteral administration of narcotic analgesics frequently given in combination with a phenotheazine derivative. This paper describes the introduction of an epidural service to the University Hospital for the relief of pain during childbirth. Fifty patients were studied. The indications included elective pain relief, pre-eclampsia, cardiac disease, premature or high risk foetus and operative delivery. The contraindications to the technique were few and included patients who were unwilling to have this form of analgesia, patients with antepartum haemorrhage, and those with a history of previous uterine surgery. The local anaesthetic agent of choice was bupviacaine (marcaine), but due to limited supplies of this drug, lignocaine in combination with adrenaline was employed in the majority of cases. The local analgesic agents were injected every two hours (bupivacaine) or every 45 - 60 minutes (lignocaine) via an indwelling Teflon epidural catheter. All patients were interviewed during the postpartum period. The forceps rate was not increased and the mothers did not feel deprived of the 'feeling' of parturition in the majority of instances. Backache during the 1st and 2nd days post delivery occurred in 60 percent of these cases. Forty-five patients (90 percent) spoke highly of the procedure and requested this form of analgesia for subsequent pregnancies (AU)