Neuraxial labor analgesia: Initiation techniques.
Best Pract Res Clin Anaesthesiol
; 36(1): 3-15, 2022 May.
Article
in En
| MEDLINE
| ID: mdl-35659957
ABSTRACT
The ideal technique for labor analgesia would have a quick onset, predictable quality, and adjustable depth and duration. Moreover, it would be easy to perform and have minimal maternal and fetal side effects. A catheter-based neuraxial approach encompasses these desirable characteristics and includes the epidural, combined spinal epidural, dural puncture epidural, and intrathecal catheter techniques. In this review, we outline the unique technical considerations, analgesic characteristics, and side effect profiles for each technique that can ultimately impact the maternal-fetal dyad. The selection of neuraxial analgesia techniques should consider the patient and team's goals and expectations, the clinical context, and the institutional culture. Labor analgesic techniques that initiate with an intentional dural puncture component have a faster onset, greater bilateral and sacral spread, and lower rates of epidural catheter failure. Further elucidation of the mechanisms, benefits, and risks of each neuraxial initiation technique will continue to benefit patients and care providers.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Labor, Obstetric
/
Analgesia, Epidural
/
Analgesia, Obstetrical
/
Anesthesia, Epidural
Type of study:
Prognostic_studies
Limits:
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
Best Pract Res Clin Anaesthesiol
Journal subject:
ANESTESIOLOGIA
Year:
2022
Document type:
Article
Affiliation country: