The correlation of antepartum upper extremity cuff algometry with epidural analgesic requirements for labor

Abstract

Background: Individual parturients experience pain differently, and it is unknown how these differences affect their requirements for labor analgesics. Materials and Methods: Cuff algometry of the upper limb was used to determine the pain thresholds and temporal summation of pain scores in nulliparous women about to undergo induction of labor. Analgesia was provided, upon request, with a patient controlled epidural analgesia infusion of bupivacaine and fentanyl. Nurse-administered epidural boluses of bupivacaine or lidocaine were given for breakthrough pain. Partial Spearman correlations were used to correlate the cuff algometry measurements with the amount of analgesic medication required by the patient. Results: There was no significant correlation between any of the algometry measurements and the number of patient or nurse administered bupivacaine boluses. There was a correlation of 0.7 (P = 0.001) between the temporal summation scores and the hourly number of nurse-administered epidural lidocaine boluses; however, this was based on only 3 patients who required lidocaine boluses. Conclusions: The use of pre-labor cuff algometry of the upper limb does not correlate with the patient epidural analgesic requirements and subsequent analgesia administration.

Keywords

• Cuff algometry
• epidural analgesia
• pain tolerance