Predictors and Management Protocol for Secondary Failure of Labor Epidural Analgesia: A Single-Center Retrospective Cohort Study
Alrefaey K. Alrefaey, Atgiaa Gornas, Najia A. Abdalla, Athmart Alhadi Yusuf Ahmed, Hamada Mangoud, Hend Abo Shanab, Khalaf Elwadeya, Mohammed HamedAbstract
Background:
Labor epidural analgesia (LEA) is the gold standard for pain relief during normal delivery. Up to 25% of parturients receiving labor epidurals may experience incomplete analgesia. The failure of epidural analgesia triggers the use of alternative techniques, adding to the cost and the risk of maternal and fetal complications. This retrospective analysis of labor epidurals focuses on the incidence of secondary failure, its associated risk factors, and the management protocol.
Methods:
Data were retrieved for patients who received labor epidurals performed between January 2023 and December 2024. The patients were divided into two groups according to the incidence of secondary failure of LEA.
Results:
The analysis included 1178 cases, with an incidence of secondary failure of LEA of 3.9%. Multiparity, a preceding incidence of primary failure, labor augmentation, and a longer infusion time were significantly associated with secondary failure, with
Conclusion:
This study highlights independent risk factors for the failure of LEA, allowing for the creation of preventive strategies for high-risk parturients. Further studies are encouraged to incorporate targeted management policies to increase maternal satisfaction and safety.