International Journal of Gynecology & Obstetrics · 2003 · 70 citations · 18 references
The analgesic efficacy and maternal satisfaction is better with epidural analgesia than with opioids. Analgesia provided by meperidine and tramadol is comparable and approximately 50% of women rated the analgesia as good. Meperidine is better in the second stage than tramadol. Hence in developing nations where availability of facilities is the main limiting factor, intramuscular opioids can be considered suitable alternatives.
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Effect of Epidural vs Parenteral Opioid Analgesia on the Progress of Labor
Stephen H. Halpern, Barbara L. Leighton, Arne Ohlsson et al. · JAMA · 1998 · 263 citations
Shiv K. Sharma, Elaine J. Sidawi, Susan M. Ramin et al. · Anesthesiology · 1997 · 230 citations · Full text