Lumbar epidural analgesia--the pursuit of perfection. With special reference to midwife participation.

Lumbar epidural block for the relief of pain in labour has been reported as having a variable frequency of success. Analysis of a personal series of 1544 epidurals carried out with the close co-operation of midwives shows that, with attention to details of management, satisfactory analgesia can be assured in well over 90% of all labours. Total failure should be a rare event and the causes of more than half the partial failures can be traced to errors of management.