A randomized, double-blind, placebo-controlled trial of epidural XXXX @entity1337 after vaginal delivery.

@entity1 @entity390 @entity1337 @entity391 @entity111 @entity1286 @entity158 @entity130
BACKGROUND: @entity158 after vaginal delivery can interfere with the activities of daily living. We hypothesized that epidural medication administered after delivery would be of benefit for acute postpartum @entity158 management. The objective of this study was to assess whether epidural @entity1286 after vaginal delivery would reduce the analgesic requirements for perineal @entity158 . METHODS: This randomized, double-blind, placebo-controlled trial included 228 parturients who received epidural @entity1286 , 2.5 mg, or epidural saline within 1 h of delivery. The primary outcome was the proportion of @entity1 who received additional analgesics in the first 24 h postpartum. We also evaluated the time to first request for @entity1337 , @entity158 and satisfaction scores, and the incidence of side effects due to epidural @entity1286 . RESULTS: The majority of the 228 @entity1 participating in the study were Caucasian, primiparous @entity1 >30 yr old. The proportion of @entity1 requiring additional analgesics was less among those who received epidural @entity1286 (8 of 113; 7%) compared with saline (37 of 115; 32%), regardless of the degree of perineal @entity130 (RR = 0.22, 95% CI: 0.12-0.41). The relative risk reduction in receiving additional analgesics for primiparous @entity1 receiving epidural @entity1286 compared with saline was 0.25 (95% confidence interval [CI]: 0.13-0.49) and for multiparous @entity1 was 0.12 (95% CI: 0.02-0.63). The time to first request for analgesics was later for those who received @entity1286 (mean 22.9 h, 95% CI: 22.2-23.7) compared with saline (mean 18.9 h, 95% CI: 17.4-20.4) (P < 0.0001). The side-effect incidence ( @entity111 , @entity390 and @entity391 , and sedation) was not different between the 2 groups. CONCLUSION: There was a 78% reduction in analgesic requirements in @entity1 given epidural @entity1286 after vaginal delivery compared with placebo for both primiparous and multiparous @entity1 . @entity1 who receive epidural labor @entity1337 for vaginal deliveries and stay in the hospital for 24 h after delivery may benefit from postpartum administration of epidural @entity1286 .
