Repeated Epidural Anesthesia and Incidence of Unilateral Epidural Block

Epidural block is today the most common method of pain relief during labor. Nowadays, facing a multiparus parturient requiring epidural for the second or third time is common due to increased frequency of using epidural analgesia during labor.

Examination of the performance and outcome of women receiving their first versus repeated epidural block.

The study included 140 American Society of Anesthesiologists (ASA) Physical Status II parturients (age range 20 to 40 years) and scheduled for normal vaginal delivery. The parturients were divided randomly into two equal groups. Group (A) in which 70 women primipara subjected to their first epidural block, while group (B) in which 70 women multipara subjected to their repeated epidural block. Our primary outcome of the study is the incidence of a unilateral block and secondary outcomes include Visual Analogue Scale (VAS) before the epidural and 30 minutes after injection of local anesthetic and details of labor as gestation and cervical dilatation.

The results showed that there was a statistically significant decrease in the incidence of a unilateral block in the group (A) when compared to the corresponding values in the group (B) (P-value < 0.05). Moreover, group (A) showed a statistically significant decrease in Visual Analogue Scale (VAS) values 30 minutes after the injection of local anesthetic (P-value < 0.05).

The conclusion of our study is that there is a higher incidence of unilateral block amongst women receiving their repeated epidurals for labour than those receiving their first epidural block.