Epidural analgesia does not prolong the second stage of labor relative to placebo, according to a trial in Obstetrics & Gynecology.
Researchers in China enrolled 400 nulliparous women who requested analgesia during labor. In the first stage of labor, patients received standard epidurals (ropivacaine, 0.8%; with sufentanil). But when the cervix was fully dilated, i.e., the second stage, patients were randomized to receive either saline or the standard epidural solution. Patients with excessive pain in the second stage could receive an unblinded infusion of the epidural drug.
The primary outcome — the duration of time between full cervical dilation and delivery — was similar between groups (about 50 minutes). The saline group scored lower on maternal satisfaction with pain relief.
The authors conclude: “Stopping the epidural infusion at the start of the second stage of labor does not affect the duration or any other outcome, with the exception of possibly resulting in lower maternal satisfaction.”