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British Journal of Anaesthesia, 2002, Vol. 89, No. 3 466-472
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

Epidural analgesia and backache: a randomized controlled comparison with intramuscular meperidine for analgesia during labour

B. A. Koughnan1,*, F. Carli2, M. Romney1, C. J. Doré3 and H. Gordon1

1 Departments of Anaesthesia and Obstetrics and Gynaecology, Northwick Park Hospital Watford Road, Harrow, Middlesex HA1 3UJ, UK
2 Department of Anesthesia, McGill University 681 Pine Avenue West, Montreal, Canada H3A 1A1
3 Medical Research Council Clinical Trials Unit 222 Euston Road, London NW1 2DA, UK

*Corresponding author

Background. Concern has been expressed that epidural analgesia for labour may be associated with a higher incidence of backache.

Methods. A prospective randomized trial investigating the effect of epidural analgesia on the outcome of labour in nulliparae, mothers were randomized to receive either epidural analgesia or meperidine. A questionnaire on postnatal symptoms was sent to them 6 months after delivery.

Results. In all, 611 mothers were studied; 310 were randomly allocated to receive i.m. meperidine up to 300 mg and 301 to receive epidural bupivacaine. The response rate to our questionnaire was 83%. Intention-to-treat analysis showed similar prevalence rates of postpartum backache in the epidural (48%) and meperidine groups (50%), with an observed difference (epidural–meperidine) of –2% (95% CI, –11 to + 6%). After excluding mothers with backache before delivery, there were also similar incidence rates of postpartum backache in the epidural (29%) and meperidine groups (28%), observed difference 1% (95% CI, –8 to + 10%).

Conclusions. Epidural analgesia in labour was not associated with an increase in the prevalence or incidence of backache.

anaesthetic techniques, epidural analgesia, obstetric analgesics opioid, mependine complications, backache


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