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Review
. 2018 Sep;62(9):658-666.
doi: 10.4103/ija.IJA_445_18.

Neuraxial techniques of labour analgesia

Sunanda Gupta  1 , Seema Partani  1
Affiliations
Review

Neuraxial techniques of labour analgesia

Sunanda Gupta et al. Indian J Anaesth. 2018 Sep.

Abstract

In recent years, many neuraxial techniques have been introduced to initiate and maintain labour analgesia, with low-dose mixtures of local anaesthetics and opioids, which have improved the quality of analgesia and made it safer for both mother and neonate. An independent search of the databases of PubMed, Medline, and Cochrane controlled trial data was conducted by two researchers, and randomized controlled trials that compared different methods of neuraxial analgesia and the different techniques of maintaining labor analgesia were retrieved and analyzed. The advantages, disadvantages, and indications of each technique along with the doses of intrathecal and epidural drugs are discussed. The myths and controversies involving neuraxial labor analgesia and the current consensus on their effect on the maternal and foetal outcomes are also outlined.

Keywords: Computer-integrated patient-controlled epidural analgesia; continuous spinal analgesia; neuraxial labour analgesia; programmed intermittent bolus.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Pain pathways of labour. (a) Visceral and somatic pain pathways. (b) Supraspinal pain pathways
Figure 2
Figure 2
Practical tips to salvage an inadequate block
See this image and copyright information in PMC

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