PATIENTS AND METHODS: Electronic and hardcopy records of labor deliveries between January 2012 and December 2015 were reviewed at KK Women's and Children's Hospital, Singapore. The primary outcome was the prevalence of episodic
pain. Demographic, clinical and
anesthetic data were retrieved. Univariate and multivariate logistic regression analyses were used to identify associated risk factors for labor episodic
pain experienced by parturients while receiving
epidural analgesia. Model performance was assessed by area under the curve (AUC) from the receiver operating characteristic curve.
RESULTS: The prevalence of labor episodic
pain was 14.2% (2,951 of 20,798 parturients). The risk factors associated with labor episodic
pain, which are given here as factor (OR, 95% CI), are the following: need for epidural resiting (11.4, 7.53-17.28), higher
pain scores intrapartum (1.34, 1.32-1.36), higher Bromage scores (1.12, 1.02-1.22), the need for instrumental delivery (1.32, 1.16-1.52), the need for cesarean delivery (1.41, 1.26-1.59), the presence of venous
puncture (1.29, 1.03-1.62), the presence of dural
puncture (14.28, 5.92-34.43), the presence of high block (6.05, 1.39-26.35), the need for a
urinary catheter (1.17, 1.17-1.34), larger volumes of
local anesthetics used (1.01, 1.01-1.01) and higher body mass index (1.01, 1.01-1.02), and decreased maternal satisfaction (0.97, 0.97-0.98). The AUC was 0.80.
CONCLUSION: Knowledge of these factors may allow for future interventions in management to prevent labor episodic
pain. Further research is needed to validate these association factors.