THE KK Women's and Children's Hospital (KKH) has found a way to further lessen the pain of childbirth.
It has developed a new way of releasing anaesthetic through the spine to numb the lower body - called an epidural - in amounts and at intervals controlled by the woman in labour.
For most women, the new way of delivering the epidural even does away with 'breakthrough pain', which is the pain that is felt despite being given anaesthetic.
Just about one in 10 of the women who received epidurals in this new way felt breakthrough pain, KKH doctors found in studies on more than 300 women over the past three years.
This is a marked improvement from epidurals delivered the conventional way, which left almost half of the women still feeling some breakthrough pain.
The improvement comes courtesy of a computer program which calibrates the amount of anaesthetic according to how much pain the mother-to-be feels.
Women in labour given the conventional epidural are usually first given an injection of the anaesthetic. They are then hooked to a pump which releases a fixed dose of the drug continuously throughout labour.
Some patients on newer pumps can even press a button to get an extra dose of the drug for their pain.
But many still feel pain because the continuous dose is standard and fixed, though pain levels vary from woman to woman and sharpen towards delivery, said Associate Professor Alex Sia, 44, head of the women's anaesthesia department at KKH.
The other problem is that, even when the woman presses the button for an extra dose of the drug 'on demand', it takes about 10 minutes for the drug to kick in.
'Ten minutes is a long time if you are in pain, so it's not ideal,' Prof Sia said.
The program he designed thus monitors how frequently the woman presses the button for extra doses and adjusts the continuous dose accordingly.
The patient still gets an epidural injection before being hooked to the pump, which at first does not release any drug.
When pain strikes, she presses the button to release a dose of the drug and to kick-start the pump into giving her a continuous dose.
If she presses the button again within an hour, the continuous dose will be upped. If she does not, it will be cut back.
Prof Sia took about 1-1/2 years to write the program and design a prototype device resembling a personal digital assistant, which is connected to the pump.
He then enlisted engineers from Nanyang Polytechnic to refine it and his hospital colleagues to test it on their patients.
One of them, Dr Yvonne Lim, a consultant anaesthesiologist, presented the results of a study at KKH's annual scientific meeting yesterday.
Following good feedback on the device, the hospital will have it in all its 32 labour rooms by the end of next year.
The $700,000 cost will be covered by a grant from the Prime Minister's Office and KKH, so parents-to-be will not have to pay more for it.
KKH is also in talks with interested parties to commercialise the system.
Dr Hoe Wan Sin, 34, a general practitioner who received epidurals in the new way for her second and third children, said: 'During the birth of my first child, 40 minutes after I was given the epidural, the pain was back as if it had never been given. I pressed the button, but part of the pain remained.
'The second and third times were much better in terms of pain relief. I was very comfortable.'
