Spinal analgesia for relief of labour pain in prima- and multiparous women Evija Austruma1 and Jonas Åkeson2 Departments of 1Anaesthesiology and Intensive Care Medicine, Central Hospital, Kristianstad, and of 2Anaesthesiology and Intensive Care Medicine, Skåne University Hospital and Lund University, Malmö, Sweden evija.austruma@skane.se CONCLUSIONS   Primaparous mothers have higher risks for instrumental delivery and intrapartum Caesarean section, but spinal analgesia for labour pain is similarly effective in primaparous and multi-parous women. AIMS   RESULTS   This descriptive study was designed to analyze effects and adverse effects of spinal analgesia for relief of labour pain in prima- and multiparous women. Compared with multiparous mothers, primaparous mothers were more often subjected to instrumental delivery (17% vs. 3.7%; P=0.0086) and intrapartum Caesarean section (7.3% vs. 0%; P=0.0142), but there were no significant differences in incidence of maternal hypotension, postdural puncture headache, use of epidural blood patch, third- or fourth-degree perineal tear or potential adverse effects on the infant. No significant differences were found in maternal satis-faction with the pain relief or use of supple-mentary regional analgesia. PATIENTS AND METHODS   The retrospective study design was ap-proved by the regional Human Research Ethics Review Board, Lund, Sweden (DNR 2015/687). We included 164 obstetrical patients (82 prima- and 82 multiparous women) given spinal analgesia with 10 µg of sufentanil for labour pain. Intrahospital maternal hypotension, postdural puncture headache, use of epidural blood patch, third- or fourth-degree perineal tear, intrapartum Caesarean section, abnormal foetal heart rate, low Apgar score, neonatal or intensive care, and breastfeeding problems were recorded. Outcome measures were maternal satisfaction with pain relief, and need for supplementary analgesia. Statistical ana-lyses were made with two-tailed unpaired student’s t-test and Fischer’s exact test. Probability (P) levels <0.05 were considered statistically significant. Maternal and foetal outcome measures Number of primaparos mothers (n=82) Number of multiparous Statistical probability (P) level Maternal hypotension 1 >0.300 Foetal bradycardia 3 2 Late foetal deceleration 10 5 0.190 Use of vacuum extraction 13 0.0091 Use of forceps Episiotomy 3rd/4th-degree perineal tear Intrapartum Caesarean section 6 0.0142 Apgar score ≤7 at 1 min 7 0.213 Apgar score ≤7 at 5 min 0.248 Use of neonatal care 0.280 Use of spinal analgesia Use of epidural analgesia 4 Use of other regional analgesia 9 0.163 Analgesia rated good/very good 82 Accidental dural puncture Postdural puncture headache Use of epidural blood patch References Loubert C, Hinova A, Fernando R. Update on modern neuraxial analgesiain labour: a review of the literature of the last 5 years. Anaesthesia 2011; 66: 191-212. doi: 10.1111/j.365-2044.2010.06616.x Mardirosoff C, Dumont L, Boulvain M, Tramèr MR. Foetal bradycardia due to intrathecal opioids for labour analgesia: a systematic review. BJOG 2002; 109: 274-81. Van de Velde M, Teunkens A, Hanssens M, Vandermeersch E, Verhaeghe J. Intrathecal sufentanil and fetal heart rate abnormalities: a double-blind, double placebo-controlled trial comparing two forms of combined spinal epidural analgesia with epidural analgesia in labor. Anesth Analg 2004; 98: 1153-9.