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Review
. 2021;11(3):348-354.
doi: 10.1007/s40140-021-00463-4. Epub 2021 Aug 18.

Update on Non-neuraxial Labor Analgesia

Dana Karol  1 , Carolyn F Weiniger  1
Affiliations
Review

Update on Non-neuraxial Labor Analgesia

Dana Karol et al. Curr Anesthesiol Rep. 2021.

Abstract

Purpose of review: This review will present recent updates for the use of non-neuraxial analgesia for laboring women.

Recent findings: Non-neuraxial labor analgesia by nitrous oxide and intravenous opioids are described, and safety concerns with regard to remifentanil administration have been a major focus of recent studies. Fentanyl and nitrous oxide offer some efficacy, albeit less than remifentanil, however with a greater safety margin.

Summary: Women may request or require alternatives to neuraxial labor analgesia, in some cases due to concurrent comorbidities. Remifentanil offers the most efficacious alternative analgesia option; however, safety concerns may preclude widespread use.

Keywords: Analgesia; Epidural; Labor; Non-neuraxial; Remifentanil; Safety.

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Conflict of interest statement

Conflict of InterestThe authors do not have any potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Data from the Remi-Safe network, illustrating increased reporting of cases using intravenous remifentanil patient-controlled analgesia for labor. These data are continually updated and available online at https://www.remipca.org/php/en/index.php#information. Permission granted for reproduction by Dr. Andrea Melber
See this image and copyright information in PMC

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