A review of randomized trials comparisons of epidural with parenteral forms of pain relief during labour and its impact on operative and cesarean delivery rate.
Ginekol Pol
; 89(8): 460-467, 2018.
Article
in En
| MEDLINE
| ID: mdl-30215467
ABSTRACT
OBJECTIVES:
The aim of this review was to summarise the available literature on different modalities of labour pain relief (epidural vs. parenteral) and to assess their impact on the rate of caesarean section deliveries and instrumental deliveries, and on the need to support the uterine contractile function. MATERIAL ANDMETHODS:
The PubMed, Web of Science and Cochrane databases were reviewed to identify articles describing the effect of labour pain relief on the course of labour. This review includes 16 studies with 7150 patients.RESULTS:
The analysis of the obtained data revealed that epidural analgesia (EA) or combined epidural and spinal anaesthesia (CESA) provided significantly better labour pain relief when compared with parenteral opioids. Conduction anaesthesia was not associated with an increase in the caesarean section delivery rate. Some authors concluded that conduction anaesthesia was associated with the need for assisted delivery.CONCLUSIONS:
Epidural analgesia is a well-recognised method of labour pain relief. It is associated with the parturient's higher satisfaction when compared to parenteral opioids. EA does not directly increase the caesarean section delivery rate, yet it can lead to instrumental deliveries (vacuum-assisted, obstetrics forceps) and a need to pharmacologically support the uterine contractile function. Further studies are required to evaluate the effect of EA on the course of labour, and methods of minimising its adverse effects.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Analgesia, Epidural
/
Cesarean Section
/
Analgesia, Obstetrical
/
Labor Pain
/
Extraction, Obstetrical
/
Analgesics, Opioid
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limits:
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
Ginekol Pol
Year:
2018
Document type:
Article
Affiliation country:
Poland