A modern approach to pain relief in labour
Keywords:обезболивание родов, эпидуральная анальгезия, роды
Until now, there are opposite points of view on the problem of pain in labour. The side effects of pain during labour can significantly affect the general condition of the woman and the fetus, the course of labour, and the prognosis. Pain relief in labour is based on the use of various pharmacological and non-pharmacological methods that reduce the level of psychological anxiety, relieve tension, and also block the conduction of pain impulse. For pain relief in labour, the full range of currently available pharmacological and non-pharmacological methods cannot be used, since many of them, simultaneously with pain relief, negatively affect the fetus and the process of childbirth. The use of neuraxial analgesia with local anaesthetic solutions at low concentrations is a safe method of pain relief during labour.
Tihtonen K, Kööbi T, Yli-Hankala A, Uotila J. Maternal hemodynamics during cesarean delivery assessed by whole-body impedance cardiography. Acta Obstetricia et Gynecologica Scandinavica [Internet]. Wiley; 2005 Mar 11;84(4):355–61. Available from: https://doi.org/10.1111/j.0001-6349.2005.00489.x
Caton D, Frölich MA, Euliano TY. Anesthesia for childbirth: Controversy and change. American Journal of Obstetrics and Gynecology [Internet]. Elsevier BV; 2002 May;186(5):S25–S30. Available from: https://doi.org/10.1016/s0002-9378(02)70180-4
Kelly A, Tran Q. The Optimal Pain Management Approach for a Laboring Patient: A Review of Current Literature. Cureus [Internet]. Cureus, Inc.; 2017 May 10; Available from: https://doi.org/10.7759/cureus.1240
Patel NP, El-Wahab N, Fernando R, Wilson S, Robson SC, Columb MO, et al. Fetal effects of combined spinal-epidural vs epidural labour analgesia: a prospective, randomised double-blind study. Anaesthesia [Internet]. Wiley; 2014 Apr 17;69(5):458–67. Available from: https://doi.org/10.1111/anae.12602
Segal S, Csavoy AN, Datta S. The Tocolytic Effect of Catecholamines in the Gravid Rat Uterus. Anesthesia & Analgesia [Internet]. Ovid Technologies (Wolters Kluwer Health); 1998 Oct;87(4):864–9. Available from: https://doi.org/10.1213/00000539-199810000-00022
Sultan P, Murphy C, Halpern S, Carvalho B. The effect of low concentrations versus high concentrations of local anesthetics for labour analgesia on obstetric and anesthetic outcomes: a meta-analysis. Canadian Journal of Anesthesia/Journal canadien d’anesthésie [Internet]. Springer Science and Business Media LLC; 2013 Aug 8;60(9):840–54. Available from: https://doi.org/10.1007/s12630-013-9981-z
Gimovsky AC, Guarente J, Berghella V. Prolonged second stage in nulliparous with epidurals: a systematic review. The Journal of Maternal-Fetal & Neonatal Medicine [Internet]. Informa UK Limited; 2016 May 5;30(4):461–5. Available from: https://doi.org/10.1080/14767058.2016.1174999
Anwar S, Anwar MW, Ayaz A, Danish N, Ahmad S. Effect of epidural analgesia on labor and its outcomes. Journal of Ayub Medical College Abbottabad. 2015 Mar 1;27(1):146-50.
Hasegawa J, Farina A, Turchi G, Hasegawa Y, Zanello M, Baroncini S. Effects of epidural analgesia on labor length, instrumental delivery, and neonatal short-term outcome. Journal of Anesthesia [Internet]. Springer Science and Business Media LLC; 2012 Sep 11;27(1):43–7. Available from: https://doi.org/10.1007/s00540-012-1480-9
Heesen M, Böhmer J, Klöhr S, Hofmann T, Rossaint R, Straube S. The Effect of Adding a Background Infusion to Patient-Controlled Epidural Labor Analgesia on Labor, Maternal, and Neonatal Outcomes. Anesthesia & Analgesia [Internet]. Ovid Technologies (Wolters Kluwer Health); 2015 Jul;121(1):149–58. Available from: https://doi.org/10.1213/ane.0000000000000743
Chau A, Bibbo C, Huang C-C, Elterman KG, Cappiello EC, Robinson JN, et al. Dural Puncture Epidural Technique Improves Labor Analgesia Quality With Fewer Side Effects Compared With Epidural and Combined Spinal Epidural Techniques. Anesthesia & Analgesia [Internet]. Ovid Technologies (Wolters Kluwer Health); 2017 Feb;124(2):560–9. Available from: https://doi.org/10.1213/ane.0000000000001798
Toledano RA, Leffert L. (2019). Neuraxial analgesia for labor and delivery (including instrumented delivery). In M. Crowley (Ed.), UpToDate. Retrieved July 17, 2019, from https://www.uptodate.com/contents/neuraxial-analgesia-for-labor-and-delivery-including-instrumented-delivery
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This work is licensed under a Creative Commons Attribution 4.0 International License