Secondary End Points
Delivery type did not differ between groups, with an overall
spontaneous vaginal delivery rate of 73% and a cesarean
delivery rate of 14% to 16% (Table 2).
The incidence of epidural top-up boluses by an anesthesiologist
was significantly less in the CSE group. The need
for epidural catheter replacement was between 1% and 2%
and not significantly different between groups (Table 3).
PCEA variables were not statistically different between
groups. Patient satisfaction was high in both groups.
Pruritus scores (mean ± SD) were higher in the CSE
compared with the epidural group (2.3 ± 2.5 vs 1.7 ± 2.4;
P = 0.002). The requirement for treatment was low in both
groups (4.6% CSE vs 3.4% epidural; P = 0.40). No differences
were found in the incidence of ephedrine use for hypotension
(Table 5). The degree of motor block between groups
was similar (data not shown).
The incidence of fetal bradycardia requiring an intervention
within 30 minutes of initiation of analgesia was 8.5% in
the CSE group versus 4.5% in the epidural group (P = 0.025;
99.5% for difference: −1.0%, 8.8%). All episodes of profound
fetal bradycardia resolved with conservative measures
alone, and there were no early emergency cesarean
deliveries in either group. Neonatal outcomes were similar
(Table 5). A comparison of outcomes associated with each
subgroup is outlined in Table 6.