Epidural analgesia has excellent clinical efficacy and safety and is the gold standard for labour pain relief.1 However, effective analgesia is dependent on the interplay of obstetric factors, anaesthetic variables, and labour progression. Hence, an estimated 0.9%–25%2–6 of parturients experience breakthrough pain,2 with an adverse impact on satisfaction and healthcare workload. Accurate a priori identification of parturients at risk for breakthrough pain would facilitate individualised risk-counselling and optimisation of labour analgesia.
