Comparison of the Effect of Epidural Bolus and Continuous Infusion of Lidocaine %1 on Pain, the Progress of Vaginal Delivery and Motor Function in Labor Epidural Analgesia

Abstract

Background: The pain of childbirth is the most severe pain that a woman experiences. This study aimed to compare the effect of epidural bolus and epidural continuous infusion of lidocaine %1 on pain and progress of vaginal delivery and motor function in labor epidural analgesia.

Methods: This randomized clinical trial was conducted on 50 pregnant women aged between 18-45 years. They were randomly assigned into two groups of bolus injections of lidocaine1% and continuous infusion using an epidural approach. The evaluated variables included systolic and diastolic blood pressures, mean arterial pressure, pain score, heart rate, satisfaction rate, nausea, vomiting, itching, the progress of delivery, and the level of motor and sensory block. The collected data were analyzed in SPSS software (Version 21). P-value less than 0.05 was considered statistically significant.

Results: Two groups were similar in age. There were no significant differences between two groups in terms of mean diastolic blood pressure, incidence of hypotension and C/S rate (P> 0.005). Mean arterial pressure, sedation score and neonatal Apgar scores in the first and fifth minutes in the continuous group were significantly lower than the bolus group. Pain score (VAS) in the bolus group) 2.55±1.04 (was significantly lower than infusion group (5.22±2.50). The length of the first and second stages of labor in the bolus group (42.28 and 34.12) was less than continuous infusion (47.04 and 47.00) (P< 0.005).

Conclusion: In women undergoing epidural analgesia, epidural bolus injection of lidocaine 1% is associated with greater analgesia and satisfaction than continuous infusion.