Low concentration lidocaine (0.5%) bolus epidurally can initiate fast-onset, effective and safe analgesia for early stage labor

There is no consensus on the optimal local anesthetic agent to initiate labor analgesia for patients in active labor. Currently used local anesthetic agents for initiating labor analgesia include 0.25% bupivacaine, 0.5% bupivacaine, 0.2% ropivacaine without or with various types and doses of opioids. All these agents are administered in incremental doses and are relatively "slow onset" in initiation of labor analgesia. We used 0.5% lidocaine 10ml as the loading dose given as an epidural bolus to initiate epidural analgesia for patients in early stages of labor. We included 32 cases (16 in Lidocaine group and 16 in Bupivacaine group). We found that 0.5% lidocaine is fast-onset, very effective and safe in initiating epidural analgesia for early stage labor.