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2. Patient preparation
a) All patients should have an IV catheter 18 gauge or larger placed and should receive a 500- to 1000-mL bolus before an epidural placement.
b) Lumbar epidural analgesia provides segmental levels of analgesia that block pain impulses from the uterus but maintain sensation in the perineum and avoid motor blockade.
(1) Generally, this is only administered when labor is well established, and the cervix is dilated 5 to 6 cm in primiparas and 3 to 4 cm in multiparas, with regular contractions.
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