(Anesth Analg. 2017;124(5):1571–1580)
Epidural analgesia may slightly prolong the second stage of labor and increase the instrumental birth rate, especially when high concentrations of local anesthetics are used. Consequently, low concentrations of local anesthetics (LCLAs) have become popular for epidural labor analgesia to help mediate second stage labor. The authors of the present study conducted a systematic review and meta-analysis to compare the effects of epidural analgesia with LCLAs with that of nonepidural analgesia on obstetric outcomes.