Comparative Study of Epidural Analgesia and Programmed Labor Analgesia in Controlling Labor Pain

Objective: To compare the efficacy, safety, and outcomes of epidural analgesia versus programmed labor analgesia for pain management during labor at a tertiary care center in Bangladesh. Materials and Method: A prospective comparative study was conducted at Bangabandhu Sheikh Mujib Medical University from July 2019 to July 2020. One hundred parturients were randomly allocated into two groups: epidural analgesia (Group A, n=50) and programmed labor analgesia (Group B, n=50). Pain intensity was assessed using Visual Analog Scale (VAS). Primary outcomes included pain relief, duration of labor, mode of delivery, and maternal satisfaction. Secondary outcomes included fetal well-being and complications. Results: Epidural analgesia provided superior pain relief (mean VAS reduction: 5.1 vs 3.6, p<0.001) and higher maternal satisfaction scores (8.4 ± 1.2 vs 6.8 ± 1.5, p<0.001). First stage labor duration was longer in Group A (295 ± 42 vs 248 ± 38 minutes, p<0.001). Spontaneous vaginal delivery rates were comparable (76% vs 84%, p=0.317). Both groups showed similar fetal outcomes with comparable Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores. Group A experienced more hypotension (8% vs 2%), while Group B had higher instances of nausea (12% vs 4%). Cost analysis favored programmed labor analgesia (4,200 ± 450 BDT vs 12,500 ± 1,200 BDT, p<0.001). Conclusion: While epidural analgesia provides better pain relief and maternal satisfaction, programmed labor analgesia offers a cost-effective alternative with acceptable pain relief and potentially shorter labor duration. Both methods demonstrate comparable safety profiles, making programmed labor analgesia a viable option in resource-limited settings. J Med Coll Women Hosp.2025; 21 (2):16-26