Epidural analgesia for labor: Current techniques

Marcos Silva, Stephen H Halpern, Marcos Silva, Stephen H Halpern

Abstract

Epidural analgesia is an extremely effective and popular treatment for labor pain. In this review, we trace the history of the use of epidural analgesia and its refinements. We then outline the goals of treatment and methods used to attain those goals. The use of low concentrations of local anesthetics, combined with lipid-soluble opioids, does not impede the progress of labor or depress the newborn. The incidence of side effects is low. Maintenance of analgesia that allows patient control enhances patient satisfaction.

Keywords: analgesia; childbirth; epidural; labor; local anesthesia; spinal.

Figures

Figure 1
Figure 1
Timeline illustrating major developments in the use of neuraxial analgesia for labor pain.
Figure 2
Figure 2
Epidural analgesia versus parenteral opioid analgesia and incidence of cesarean section. The number of patients who had a cesarean section, odds ratio, and 95% confidence interval are shown for each study. The size of the box is proportional to the weight of the study in the meta-analysis. The scale is logarithmic. For studies with no cesarean sections, the odds ratio could not be calculated. Copyright © 2005, Blackwell Publishing. Reproduced with permission from Leighton BL, Halpern SH. Epidural analgesia and the progress of labor. In: Halpern SH, Douglas MJ, editors. Evidence-based Obstetric Anesthesia. Oxford, UK: Blackwell Publishing; 2005.

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Source: PubMed

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