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

ng labor is often a case-by-case decision, and the combination approach might have its own drawbacks.

"The study confirms what we know previously -- namely, that the [combination approach] provides faster onset pain relief [by a few minutes] but is associated with a greater incidence of side effects including itching and low fetal heart rates," said Dr. Grant Gilbert, an obstetrician/gynecologist at NYU Langone Medical Center in New York City.

He added, however, that even though the rate of low fetal heart rate was a bit higher among women in the study who got the combination pain relief, "no patient required emergency cesarean for this fetal heart rate problem."

Gilbert also added that some doctors avoid the intrathecal approach due to a higher risk for meningitis, although this is an "admittedly rare complication" and there were no such incidents in the study.

"The bottom line is that both epidural and [the combination] techniques may be used to provide profound pain relief during labor," said Gilbert, who is also associate professor in the department of anesthesiology at NYU Langone. "Ultimately, each practitioner administers the type of analgesia that s/he considers to be best for their patient."

Another expert said the combination approach might have an edge in many cases.

"Combined spinal epidural anesthesia offers significantly better and faster relief for patients in labor, [and] there was no increase in side effects or cesarean sections, either," said Dr. Jennifer Wu, ob/gyn at Lenox Hill Hospital in New York City. "For patients who desire pain relief in labor, this is good information."

More information

The American Society of Anesthesiologists has more about pain management during childbirth.

-- Robert Preidt

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