Update on modern neuraxial analgesia in labour: a review of the literature of the last 5 years

@article{Loubert2011UpdateOM,
  title={Update on modern neuraxial analgesia in labour: a review of the literature of the last 5 years},
  author={Christian Loubert and Anelia Hinova and Roshan Fernando},
  journal={Anaesthesia},
  year={2011},
  volume={66}
}
Several strategies and alternative therapies have been used to provide analgesia for labour pain. Over the last few years, a number of improvements have enhanced the efficacy and safety of neuraxial analgesia and ultimately have improved mothers’ satisfaction with their birth experience. As labour analgesia is a field of obstetric anaesthesia that is rapidly evolving, this review is an update, from a clinical point of view, of developments over the last 5–7 years. We discuss advantages and… 
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Modern neuraxial labour analgesia
TLDR
Recent developments in pump technology and epidural delivery systems are examined to evaluate how these have enhanced the mothers’ birthing experiences.
Maintenance of neuraxial block in labor analgesia
Maintenance of epidural labour analgesia: The old, the new and the future.
  • B. Sng, A. Sia
  • Medicine
    Best practice & research. Clinical anaesthesiology
  • 2017
[Neuraxial labor analgesia: a literature review].
Neuraxial labor analgesia: a literature review
Obstetric analgesia – update 2016
Abstract Neuraxial labor analgesia can be initiated via combined spinal-epidural (CSE) or stand-alone epidural. Pros and cons of these techniques are outlined in this review. In recent years…
Impact of Drug Delivery Systems on Neuraxial Labor Analgesia
TLDR
This review examines the several strategies for maintenance of neuraxial labor analgesia with a focus on the impact of drug delivery systems in the past, present and future.
Central neuraxial analgesia for labor: an update of the literature.
TLDR
This narrative review focuses on the literature relating to central neuraxial labor analgesia from the past 5 years, from November 2010 to October 2015, and discusses the evidence related to the various central neuronaxial techniques used, the increasingly widespread use of ultrasound guidance and the evidence surrounding other novel methods of central neurAXial block insertion.
Analgesia and anaesthesia in labour
ReviewAnalgesia and anaesthesia in labour
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References

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TLDR
The short-term complications of the analgesic techniques used during labour were not very relevant with respect to the subjects' satisfaction, and Epidural and spinal-epidural analgesia to relieve pain during labour can be considered safe and reliable.
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TLDR
CI-PCEA reduced the incidence of breakthrough pain without the evidence of increasing drug consumption when compared with CEI, and was able to convert an ordinary infusion pump to one which analyses the patients' needs in the previous hour and automatically adjusts the basal infusion accordingly.
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TLDR
Epidural analgesia appears to be effective in reducing pain during labour, however, women who use this form of pain relief are at increased risk of having an instrumental delivery and further research may be helpful to evaluate rare but potentially severe adverse effects of epidural analgesIA on women in labour and long-term neonatal outcomes.
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TLDR
CSE is a safe and good alternative to EA as a technique of neuraxial block for labour analgesia and no difference in the mode of delivery was detected between the two groups.
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TLDR
No difference was found between CSE and epidural techniques with regards to maternal mobility, rescue analgesia requirements, the incidence of post dural puncture headache, hypotension, urinary retention, mode of delivery, or admission of the baby to the neonatal unit.
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  • Medicine
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TLDR
Given the incidence of fetal bradycardia observed in both groups of Rofaeel’s study, perhaps it is time to reassess whether CSE should continue to have a role in labour analgesia, and one might conclude that IT isobaric bupivacaine should no longer be used.
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TLDR
In the PIEB group, a reduction of the total local anesthetic dose and the n of PCEA boluses which were requested later in labor process, which suggested a more tailored analgesia, may explain the absence of motor block.
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TLDR
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TLDR
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TLDR
High volume, dilute local anesthetic solutions with a continuous background infusion appear to be the most successful strategy in patient-controlled epidural analgesia for labor.
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