A survey of epidural analgesia for labour in the United Kingdom

A postal survey of obstetric units throughout the UK was conducted to obtain information about the provision of epidural analgesia for labour. Ninety per cent of units offered a 24‐h epidural service and the average epidural rate was 24%. The most commonly administered epidural test dose was 3 ml of bupivacaine 0.5% and bupivacaine 0.25% was most often used as the initial epidural top‐up. Continuous infusions of low‐dose bupivacaine and opioid mixtures were the most popular method of maintenance epidural analgesia. Twenty‐four per cent of units offered combined spinal–epidural analgesia in addition to standard epidural analgesia. Midwives played a prominent role in the administration of epidural bolus top‐ups and also in the assessment and maintenance of continuous epidural infusions.

[1]  T. Jaspan,et al.  Anaesthesia for Caesarean section in a patient with recent subarachnoid haemorrhage and severe pre‐eclampsia , 1999, Anaesthesia.

[2]  S. A. Helmy,et al.  Prophylactic anti‐emetic efficacy of ondansetron in laparoscopic cholecystectomy under total intravenous anaesthesiaA randomised, double‐blind comparison with droperidol, metoclopramide and placebo , 1999, Anaesthesia.

[3]  G. Djaiani,et al.  Propofol auto‐co‐induction as an alternative to midazolam co‐induction for ambulatory surgery , 1999, Anaesthesia.

[4]  G. Lyons,et al.  Spinal analgesia in labour. , 1997, International journal of obstetric anesthesia.

[5]  P. Royston,et al.  Comparison of 15 mg and 25 mg of bupivacaine both with 50 microg fentanyl as initial dose for epidural analgesia. , 1996, International journal of obstetric anesthesia.

[6]  S. Office Report on Confidential Enquiries into Maternal Deaths in the United Kingdom 1991-1993 , 1996 .

[7]  M. Paech Patient-controlled epidural analgesia in obstetrics. , 1996, International journal of obstetric anesthesia.

[8]  R. Russell,et al.  Epidural infusion of low‐dose bupivacaine and opioid in labour Does reducing motor block increase the spontaneous delivery rate? , 1996, Anaesthesia.

[9]  B. Morgan ‘Walking’ epidurals in labour , 1995, Anaesthesia.

[10]  D. Davies,et al.  Randomised comparison of combined spinal-epidural and standard epidural analgesia in labour , 1995, The Lancet.

[11]  R. Collis,et al.  Meningitis after combined spinal-extradural anaesthesia in obstetrics. , 1995, British journal of anaesthesia.

[12]  A. Asbury,et al.  Continuous extradural analgesia: comparison of midwife top-ups, continuous infusions and patient controlled administration. , 1993, British journal of anaesthesia.

[13]  M. Baxandall,et al.  Combined spinal epidural analgesia with ability to walk throughout labour , 1993, The Lancet.

[14]  M. W. Davies,et al.  Current practice of epidural analgesia during normal labour , 1993, Anaesthesia.

[15]  A. Holdcroft Use of adrenaline in obstetric analgesia , 1992, Anaesthesia.

[16]  G. Cooper,et al.  Bupivacaine versus bupivacaine plus fentanyl for epidural analgesia: effect on maternal satisfaction. , 1991, BMJ.

[17]  R. Lamont,et al.  Continuous Versus Intermittent Epidural Analgesia: A Randomised Trial to Observe Obstetric Outcome , 1990 .

[18]  D. Scott,et al.  The availability of epidural anaesthesia and analgesia in obstetrics , 1990, British journal of obstetrics and gynaecology.

[19]  I. Wilson,et al.  An epidural infusion technique for labour , 1987, Anaesthesia.

[20]  D. Gambling Epidural infusions in labour should be abandoned in favour of patient-controlled epidural analgesia. , 1996, International journal of obstetric anesthesia.

[21]  D. Bush A comparison of informed consent for obstetric anaesthesia in the USA and the UK. , 1995, International journal of obstetric anesthesia.

[22]  B. Leighton,et al.  Complications of labor analgesia: epidural versus combined spinal epidural techniques. , 1994, Anesthesia and analgesia.