Neuraxial analgesic techniques are the gold standards for pain relief during labour and delivery. Despite the increased use and known benefits of neuraxial labour analgesia, there has been significant controversy regarding the impact of neuraxial analgesia on labour outcomes. Review of the evidence suggests that effective neuraxial labour analgesia does not increase the rate of Caesarean delivery, even when administered early in the course of labour; however, its use is associated with a prolonged second stage of labour. Effective second-stage analgesia might also be associated with an increased rate of instrumental vaginal delivery.
