الفهرس 
Normal labourOnly 14 pages are availabe for public view
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Abstract
The aim of this study is to elaborate efficacy of the epidural analgesia versus pethidine intramuscular injection as methods for relieving labour pain. To achieve this aim the study was done in the obstetrics and gynecology department in Ain Shams University Hospital as a group of patients was divided into 2 subgroups each one consists of 30 women one of these group received epidural anesthesia and the other received intramuscular pethidine, the effect of these two methods was assessed using VAS before and after administration of the method at 10, 45, and 90 minutes, and 24 hours after delivery.
Regarding the personal data of the participating females the study showed that the mean age for group 1 was 26.4 ± 1.45 compared to 26.8 ± 1.58 with no significant statistical difference (p > 0.05). Also the study showed that there is no significant statistical difference between the 2 groups regarding the gestational age of the studied subjects and the cervical dilatation.
Comparing the cervical dilatation rate between the two study groups there was significant statistical difference (p < 0.05) as the rate is slower in the epidural group than that in the pethidine group this finding is consistent with earlier studies. The study showed also no statistical difference between the two groups regarding the presentation of the fetus.
The administration of both epidural analgesia and intramuscular pethidine was associated with a decrease in the perception of pain in both groups although not abolishing it completely. VAS showed a decrease after 10 minutes of administration of each method, mean VAS was 4.2 in epidural group and 6.23 in pethidine group, this shows a strong statistical difference in favor of epidural anesthesia (p < 0.05). The weak effect of pethidine could be attributed to the nature of the intramuscular injection.
The VAS scores between the two groups at 45 and 90 minutes showed that the epidural anesthesia was more effective than the intramuscular pethidine. After 45 minutes of administration the pain experienced in the epidural group was lower than the pethidine group (means; 2.67 and 3.97 respectively, p < 0.05), and also after 90 minutes epidural group experienced lower pain than the pethidine group (means; 3.23 and 4.73 respectively, p < 0.05). After 24 hours of labor the VAS score was higher in the pethidine group than of the epidural group (2.2 and 2.13 respectively).
While the optimal comparison between epidural and pethidine analgesia would be assessed in a prospective randomized controlled trial, this observational study clearly demonstrates the great advantage of epidural analgesia during labor. It supports the results of previous studies which found intrapartum epidural analgesia to be more effective than parenteral analgesia in the relief of pain and discomfort.