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Combo Treatment Might Beat Epidural to Ease Labor: Study
Date:3/5/2013

TUESDAY, March 5 (HealthDay News) -- In the first stage of labor, a combined spinal-epidural technique provides faster and better pain relief compared to traditional epidural pain relief, a new study suggests.

The research included 800 healthy women who required pain relief during childbirth, and who were divided into two groups. One group received standard epidural pain relief, which involves injections of local anesthetic and pain medications into the epidural space, inside the membranes covering the spinal cord.

The other group received the combination approach, which starts with medications injected into the intrathecal space, the deeper space directly around the spinal cord, before using an epidural injection.

After the initial epidural or intrathecal injections, both groups received patient-controlled epidural analgesia. The effectiveness of pain relief, rated on a 0-to-10 scale, was compared at different times during labor and delivery.

During the first state of labor, the typical pain score was 1.4 (out of 10) for women receiving the combo therapy and 1.9 for those receiving standard epidural analgesia. This difference was statistically significant, according to a team led by Dr. David Gambling of Sharp Mary Birch Hospital for Women and Newborns in San Diego.

The study also found that complete pain relief was achieved an average of 11 minutes faster among women in the combo therapy group than those in the standard epidural group. Women who got the combination of pain relievers were also less likely to require additional epidural "top-up" doses to maintain good pain control.

Side effects were similar in both groups and there was no significant difference in the type of delivery, with cesarean section rates of 14 percent to 16 percent, concluded the study, which is published in the March issue of the journal Anesthesia & Analgesia.

Experts agreed, however, that pain relief duri
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