Effective method of labour pain relief with 0.125% bupivacaine

Background: Labour pain can be deleterious for mother and baby. Epidural analgesia relieves labour pains effectively with minimal maternal and foetal side effects. A prospective open label study was undertaken to ascertain effective dosing regime for epidural in labour.
Methods: Hundred women with singleton foetus in vertex position were included. Epidural catheter was inserted in L2-3 / L3-4 interspinous space. Initial bolus of 10-12 ml (0.125% bupivacaine) solution was injected and after the efficacy of block was established, an epidural infusion of the same drug solution was started at the rate of 10 ml/hour.
Results: In first stage of labour 80% of the parturient had excellent to good pain relief (visual analogue scale 1 to 3) with standard protocol while 20% parturient required one or more additional boluses. For the second stage, pain relief was good to fair (VAS 4-6) for most of the parturient. The incidence of caesarian section was 4% and 6% needed assisted delivery. No major side effects were observed.
Conclusion: 0.125% bupivacaine maximizes labour pain relief and minimizes side effects.