Outcomes of epidural anesthesia in low-risk obstetrical cases

The use of epidural anesthesia in obstetrics has increased markedly in the last decade, and some authorities are now stating that epidural block may be the delivery method of choice for most women. In spite of this growth in popularity, no studies have been reported which deal with the outcomes of epidural anesthesia in low-risk obstetrical cases. A retrospective cohort study of factors associated with epidural anesthesia in a low-risk obstetrical population was performed. Epidural anesthetics were administered by obstetrical anesthesiologists and patients were monitored by nurses experienced with epidural anesthesia. Although retrospective studies cannot establish cause and effect relationships, it was found, when compared to non-epidural deliveries, that epidural anesthesia deliveries were associated with more inductions of labor, lengthened times of the stages of labor, higher use of low forceps for deliveries, increased use of and greater amounts of oxytocin, increased use of the fetal heart monitor, and greater total costs. Thus, although epidural anesthesia was observed in general to be a very safe procedure, three of these variables (higher use of low forceps, increased use of oxytocin, and greater total costs) may be of some clinical importance and should be considered by both the delivering physician and the patient when deciding on a type of obstetrical anesthesia.