Epidural analgesia in labor: A narrative review

Int J Gynaecol Obstet. 2022 Nov;159(2):356-364. doi: 10.1002/ijgo.14175. Epub 2022 Mar 21.


Lumbar epidural is the most effective form of pain relief in labor with around 30% of laboring women in the UK and 60% in the USA receiving epidural analgesia. Associations of epidural on maternal, obstetric, and neonatal outcomes have been the subject of intense study, though a number of uncertainties persist. The present narrative review explores important areas of research surrounding epidural analgesia in obstetric patients including methods of initiation and administration, choice of local anesthetic solution, and the addition of adjuvants. Key meta-analyses exploring associations of epidural analgesia on maternal and neonatal outcomes are identified and summarized.

Keywords: epidural; labor analgesia; maternal outcomes; neuraxial; obstetric analgesia; obstetric outcomes.

Publication types

  • Review

MeSH terms

  • Analgesia, Epidural* / adverse effects
  • Analgesia, Obstetrical* / methods
  • Anesthetics, Local
  • Female
  • Humans
  • Infant, Newborn
  • Labor Pain* / drug therapy
  • Labor, Obstetric*
  • Pregnancy


  • Anesthetics, Local