Analgesia for forceps delivery

Nikpoor, Payam; Bain, Emily

doi:10.1002/14651858.cd008878.pub2

Cited by 15 publications

(15 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Oral NSAIDs, such as diclofenac or ibuprofen, have been shown to be beneficial for perineal pain and provide better analgesia than paracetamol or placebo. Paracetamol has a good safety record in the postnatal period and is used regularly in postoperative pain Evidence level 1++ …”

Section: Aftercare Following Assisted Vaginal Birthmentioning

confidence: 99%

Assisted Vaginal Birth

Murphy¹,

Strachan²,

Bahl³

et al. 2020

BJOG

View full text Add to dashboard Cite

Ensure obstetric trainees receive appropriate training in vacuum and forceps birth, including theoretical knowledge, simulation training and clinical training under direct supervision. [New 2020] P Competency should be demonstrated before conducting unsupervised births. [New 2020] P Complex assisted vaginal births should only be performed by experienced operators or under the direct supervision of an experienced operator. D Who should supervise assisted vaginal birth? An experienced operator, competent at midpelvic births, should be present from the outset to supervise all attempts at rotational or midpelvic assisted vaginal birth. D Where should assisted vaginal birth take place? RCOG Green-top Guideline No. 26 e73 of e112 ª 2020 Royal College of Obstetricians and Gynaecologists P Discontinue vacuum-assisted birth if there have been two 'pop-offs' of the instrument. Less experienced operators should seek senior support after one 'pop-off' to ensure the woman has the best chance of a successful assisted vaginal birth.

show abstract

Section: Aftercare Following Assisted Vaginal Birthmentioning

confidence: 99%

Assisted Vaginal Birth

Murphy¹,

Strachan²,

Bahl³

et al. 2020

BJOG

View full text Add to dashboard Cite

show abstract

“…Severe pain was less likely to be reported with the use of spinal anaesthesia (RR 0.02, 95%CI 0.00–0.27) compared with pudendal nerve blockade. All women receiving spinal anaesthesia reported effective analgesia compared with only 29% of women receiving pudendal nerve blockade (RR 3.36, 95%CI 2.46–4.60) [23]. Neither technique was associated with hypotension.…”

Section: Intrapartum Analgesiamentioning

confidence: 99%

“…A Cochrane review by Nikpoor et al. in 2013 aimed to assess the effectiveness and safety of different analgesic agents and methods available for operative vaginal delivery [23]. They concluded there was insufficient evidence from the four included randomised controlled trials, including a total of 388 women, to determine the most effective and safest analgesic agent or technique for women undergoing operative vaginal delivery.…”

Section: Intrapartum Analgesiamentioning

confidence: 99%

“…They concluded there was insufficient evidence from the four included randomised controlled trials, including a total of 388 women, to determine the most effective and safest analgesic agent or technique for women undergoing operative vaginal delivery. In addition to the above study by Hutchins et al., three studies compared diazepam with ketamine, vinydan‐ether and either general or local anaesthesia [23]. Included trials had a high or unclear risk of bias and were of low quality.…”

Section: Intrapartum Analgesiamentioning

confidence: 99%

See 1 more Smart Citation

Regional anaesthesia for labour, operative vaginal delivery and caesarean delivery: a narrative review

Sultan

Carvalho

2021

Anaesthesia

View full text Add to dashboard Cite

Summary This narrative review discusses recent evidence surrounding the use of regional anaesthesia in the obstetric setting, including intrapartum techniques for labour and operative vaginal delivery, and caesarean delivery. Pudendal nerve blockade, ideally administered by an obstetrician, should be considered for operative vaginal delivery if neuraxial analgesia is contraindicated. Regional techniques are increasingly utilised in clinical practice for caesarean delivery to minimise opioid consumption, reduce pain, improve postpartum recovery and facilitate earlier discharge as part of enhanced recovery protocols. The evidence surrounding transversus abdominis plane and quadratus lumborum blockade supports their use when: long‐acting neuraxial opioids cannot be administered due to contraindications; if emergency delivery necessitates general anaesthesia; or as a postoperative rescue technique. Current data suggest quadratus lumborum blockade is no more effective than transversus abdominis plane blockade after caesarean delivery. Transversus abdominis plane blockade, wound catheter insertion and single shot wound infiltration are all effective techniques for reducing postoperative opioid consumption, with transversus abdominis plane blockade favoured, followed by wound catheters and then wound infiltration. Ilio‐inguinal and iliohypogastric, erector spinae plane and rectus sheath blockade all require further studies to determine their efficacy for caesarean delivery in the presence or absence of long‐acting neuraxial opioids. Future studies are needed to: compare approaches for individual techniques; determine which combinations of techniques and dosing regimens result in optimal analgesic and recovery outcomes following delivery; and elucidate the populations that benefit most from regional anaesthesia in the obstetric setting.

show abstract

“…In addition to spontaneous deliveries, it has been used in operative vaginal terminations of labour (forceps deliveries) [ 4 – 6 ]. For operative vaginal deliveries, comparative studies have been performed on the use of spinal analgesia and pudendal nerve block [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of New Peripudendal Block (PPB) in the Second Stage of Labour on Perineal Relaxation and on the Reduction of Episiotomy Rate: A Randomized Control Trial

Beke

2022

Obstetrics and Gynecology International

View full text Add to dashboard Cite

Background and Objectives. We developed a new procedure peripudendal block (PPB) by modifying the traditional pudendal nerve block (PNB). Methods. In a prospective randomized study, we examined the extent to which the PPB we developed changed the rate of episiotomies, injury rates. Results. A total of 333 primiparas and 324 multiparas were included in the study. In the case of primiparas, we used the PPD procedure in 133 cases, while in the case of multiparas, we used it in 103 cases. The rate of episiotomy in primiparas was 89/133 (66.9%) with PPD and 181/200 (90.5%) without PPD p < 0.02 . In multiparas, the episiotomy rate was 30/103 (29.1%) with PPD and 140/221 (63.3%) without PPD p < 0.02 . In the case of primiparas, the rate of perineal injury and lesion was 33/133 (24.8%) with PPD, while without PPD it was 12/200 (6.0%). Examining the need for all surgical care (due to episiotomy and/or injury), a total of 103/133 cases of operative surgery were required with PPD (77/4%) while 183/200 cases were required without PPD (91.5%) p < 0.02 . In the case of multiparas, the rate of perineal injury and lesion was 11/103 (10.7%) with PPD, while without PPD it was 9/221 (4.1%). In the case of multiparas, a total of 41/103 cases required surgical care with PPD (39.8%), while without PPD, 147/221 cases required surgical care (66.5%) p < 0.02 . Conclusion. The PPB is simpler, requires less medication, can be easily mastered, and perineal relaxation can also be observed, reducing the need for an episiotomy.

show abstract

Analgesia for forceps delivery

Cited by 15 publications

References 14 publications

Assisted Vaginal Birth

Assisted Vaginal Birth

Regional anaesthesia for labour, operative vaginal delivery and caesarean delivery: a narrative review

Effect of New Peripudendal Block (PPB) in the Second Stage of Labour on Perineal Relaxation and on the Reduction of Episiotomy Rate: A Randomized Control Trial

Contact Info

Product

Resources

About