Neuraxial labor analgesia: a literature review

Aragão, Fábio Farias de; Aragão, Pedro Wanderley de; Martíns, Carlos Eduardo; Leal, Karlla Fernanda Custódia Silva; Tobias, Alexandro Ferraz

doi:10.1016/j.bjane.2018.12.014

Cited by 7 publications

(7 citation statements)

References 50 publications

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“…With NLA, the rate of cesarean and assisted vaginal delivery was less than spontaneous vaginal delivery. This finding was consistent with previous studies [5, 6, 7, 16]. But, a Cochrane review of 23 trials found that NLA increased the rate of instrumental deliveries (RR 1.42, 95% CI 1.28–1.57) compared to non‐NLA [5].…”

Section: Discussionsupporting

confidence: 92%

“…However, NLA has the risk of accidental dural puncture, headache, hypotension, itchiness, fever, infection, and anaphylaxis [5–7]. It also carries a myth of increased cesarean rates, labor prolongation, instrumental deliveries, and future backache [5, 6, 8]. Previous studies have also found that NLA increases neonatal intensive care unit (NICU) admission, neonatal birth injury from instrumental delivery, and respiratory depression [5, 8].…”

Section: Introductionmentioning

confidence: 99%

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Childbirth in Bhutan: A study on the use of neuraxial analgesia for labor pain

Yoezer¹,

Gyeltshen²,

Tshering³

2023

Public Health Challenges

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Background The practice of neuraxial labor analgesia (NLA) as a mode of pain relief was introduced in Bhutan in 2016 despite it being in practice for more than five decades. There is a lack of data on NLA in Bhutan. Therefore, this study describes the use of NLA and its outcome over 4 years in Bhutan. Methods A retrospective descriptive study was conducted from 1 January 2018 to 31 December 2021. The data were obtained from the Anesthesia Department, medical records, admission forms, and birth‐registers. A total of 524 women were included. Data were recorded using 2021 Microsoft Excel version 16.57 (22011101) and analyzed using Epi Info 7.2.5.0. Categorical data were summarized using frequencies and percentages. Continuous data were summarized using mean and standard deviation. Results The incidence of NLA usage was 3.5% (524/15,119). Most women were between 21 and 30 years (67.2%). Modes of delivery following NLA were spontaneous vaginal delivery, cesarean section, and assisted vaginal delivery 63.4%, 18.4%, and 18.3%, respectively. Non‐reassuring fetal status (37.5%) and failed progression of labor (36.5%) were the leading indications of cesarean section. The primary reason for assisted vaginal delivery was poor maternal effort (55.2%). Neonates of the mother who received neuraxial analgesia had neonatal jaundice in 8%, neonatal intensive care unit admission in 0.76%, and Apgar score less than 7 in 5.1% and 0.2% at 1 and 5‐min, respectively, after birth. Conclusion Although NLA is safe for both mothers and babies, its use is low in Bhutan. The probable reason for the low incidence could be a shortage of anesthesiologists, cultural beliefs, and lack of awareness. The Ministry of Health and the Department of Anesthesia should work together to improve the service.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Childbirth in Bhutan: A study on the use of neuraxial analgesia for labor pain

Yoezer¹,

Gyeltshen²,

Tshering³

2023

Public Health Challenges

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“…Parturients did not complain of any discomfort such as pain or bleeding from the site of epidural catheter insertion at the time of discharge from the hospital. The same had been reported by Aragao et al .,[ 18 ] in their review of literature. Among parturients who received labor analgesia, 93.3% of them graded maternal satisfaction rate as satisfactory at the time of discharge [ Table 6 ].…”

Section: Discussionmentioning

confidence: 99%

Progress of labor and obstetric outcome in parturients with combined spinal–epidural analgesia for labor: A comparative study

et al. 2021

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“…I read the article entitled “Neuraxial labor analgesia: a literature review” with great interest. 1 Labor is one of the most memorable events in every woman’s life, but labor pain can make it one of their most unpleasant experiences. For this reason, in recent decades many pregnant women have tended to cesarean section.…”

mentioning

confidence: 99%

“…Fortunately, though, fighting labor pain by new modalities provided by the anesthesia team have opened up new hopes for mothers. However, the complexity of the best methods, such as continuous spinal epidural analgesia, 1 , 2 does not allow all mothers to enjoy the same way. On the other hand, as pain per se is a subjective matter, the satisfaction of a mother from applied pain reduction method is strongly influenced by factors such as her socioeconomic level.…”

mentioning

confidence: 99%