HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

[Epidural analgesia in labor: specific characteristics, dilemmas and controversies].

AbstractINTRODUCTION:
Epidural analgesia has become the most popular method for labor pain relief. Analgesia in Labor: Yes or No? Labor pain is a complex phenomenon with sensory, cognitive, motivational, emotional, social, and cultural variables. Pain and anxiety lead to adrenergic hyperactivity, hyperventilation, hypocapnia with reduced uteroplacental blood flow and uncoordinated uterine activity, so pain relief is recommended and even indicated in cases of maternal comorbidity. Analgesia in Labor: Method of Choice. The quality of epidural analgesia is better than the one achieved by parenteral or inhalation agents, with increased uteroplacental blood flow and improved fetal-maternal oxygenation. Epidural Analgesia in Labor: What is Specific? The increased weight, lumbar lordosis, soft tissue edema and engorgement of epidural veins make it more difficult to perform epidural block in pregnancy. Epidural puncture should be performed by medial approach, at L2-3 or L3-4 level by loss of resistance technique between contractions. Epidural Analgesia in Labor: What With? Local anesthetics, bupivacaine, levobupivacaine, ropivacaine, are used and they can be combined with small doses of opioids (fentanyl or sufentanyl). Epidural Analgesia in Labor: How? Available techniques are epidural, spinal and combined spinal--epidural analgesia. Epidural Analgesia in Labor: Controversies. The most important controversy is the influence ofepidural analgesia on operative or instrumental delivery rate. Low concentrations of local anesthetic in combination with small doses of opioids, together with active management of labor by an obstetrician, would lead to increased spontaneous delivery rate.
CONCLUSION:
Although there still are some difficulties, complications and controversies, epidural analgesia provides safe and effective labor pain control.
AuthorsMarija Kutlesić, Ranko Kutlesić
JournalMedicinski pregled (Med Pregl) 2012 Sep-Oct Vol. 65 Issue 9-10 Pg. 441-7 ISSN: 0025-8105 [Print] Serbia
PMID23214341 (Publication Type: English Abstract, Journal Article, Review)
Topics
  • Analgesia, Epidural
  • Analgesia, Obstetrical
  • Female
  • Humans
  • Pregnancy

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: