Local and regional anaesthesia: epidural analgesia in labour: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Local and regional anaesthesia: epidural analgesia in labour

Sample item

A primigravida requests pain relief in labour. Compared with systemic opioids such as pethidine, which statement about epidural analgesia is supported by evidence?

AIt reduces the need for instrumental deliveryBIt shortens the second stage because the pelvic floor relaxesCIt gives superior pain relief without increasing the caesarean section rateDIt increases the caesarean section rate through dystocia

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. It gives superior pain relief without increasing the caesarean section rate

Epidural analgesia provides better pain relief than systemic opioids and does not increase caesarean delivery. It may prolong the second stage and slightly raise instrumental delivery, and it avoids neonatal opioid depression, which is a concern with pethidine.

Option by option

A. It reduces the need for instrumental delivery
Instrumental delivery is not reduced and may be slightly increased.
B. It shortens the second stage because the pelvic floor relaxes
The second stage is not shortened and may be lengthened.
C. It gives superior pain relief without increasing the caesarean section rate (correct)
Correct. It is the most effective labour analgesia without a higher caesarean rate.
D. It increases the caesarean section rate through dystocia
Randomised trials have not shown a rise in caesarean delivery.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, It gives superior pain relief without increasing the caesarean section rate. Epidural analgesia provides better pain relief than systemic opioids and does not increase caesarean delivery.

Why is "It reduces the need for instrumental delivery" not the answer?

Instrumental delivery is not reduced and may be slightly increased.

Why is "It shortens the second stage because the pelvic floor relaxes" not the answer?

The second stage is not shortened and may be lengthened.

Why is "It increases the caesarean section rate through dystocia" not the answer?

Randomised trials have not shown a rise in caesarean delivery.

What concept does this question test?

It tests Local and regional anaesthesia: epidural analgesia in labour in Anaesthesia. It may prolong the second stage and slightly raise instrumental delivery, and it avoids neonatal opioid depression, which is a concern with pethidine.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Local and regional anaesthesia: epidural analgesia in labour?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.