Self-service – the future of epidurals?

Giving you control over your own epidural during labour could reduce the need for medical intervention, finds study

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Having an epidural on demand during labour could actually reduce how much pain relief you need
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In a study of 270 women giving birth, a third tried the self-service technique and used 30% less anaesthetic than those given a steady infusion of drugs, research from the Long Beach Memorial Medical Center in California revealed.

Epidurals are usually given at a steady rate, controlled by the doctor present during birth. However, the women in the test were given control over their own epidurals, by pressing a button when they felt they needed more pain relief.

The women using the self serve method (called patient-controlled epidural analgesia – PCEA) were unable to constantly request pain relief, as after each press of the button the handheld device would lock-out for a small period of time.

The study showed that the women using PCEA were as satisfied as those who used the traditional epidural method. However some women using the self-controlled method reported more pain in the later stages of labour.

There was also evidence that the need for forceps or a ventouse to help deliver the baby was reduced for women who used PCEA.

Currently, only one fifth of hospitals in the UK have the self-service system as they come at a very high cost. Researchers are currently looking into whether the advantages of the PCEA are enough to justify the costs.

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“The technique reduces the need for anaesthetic which in turn reduces the need for forceps delivery – and it gives women a feeling of control. The question is whether the small clinical advantages are enough to justify the cost of new equipment and staff training,” Dr Elizabeth McGrady, a honorary clinical lecturer in anaesthetics at Glasgow University said to the BBC.

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