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

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.