Neuraxial analgesia effects on labour progression: facts, fallacies, uncertainties and the future

Grant, Erica N.; Tao, Weike; Craig, Margaret G.; McIntire, Donald D.; Leveno, Kenneth J.

doi:10.1111/1471-0528.12966

Cited by 55 publications

(41 citation statements)

References 63 publications

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“…These sensory nerves also convey pain information during labor, an unpleasant sensation that is blockaded with epidural analgesia. However, this procedure seems to have a negative impact on the delivery process . The anatomical relationship in the PDN and pelvic nerve origin (S2‐S3) may allow for diffusion of epidural analgesia so that, it not only affects the PDN but also the sensory and autonomic innervation of pelvic viscera, decreasing sensory information necessary to trigger the fetus expulsion reflex.…”

Section: Discussionmentioning

confidence: 99%

“…However, this procedure seems to have a negative impact on the delivery process. 23 The anatomical relationship in the PDN and pelvic nerve origin (S2-S3) may allow for diffusion of epidural analgesia so that, it not only affects the PDN but also the sensory and autonomic innervation of pelvic viscera, decreasing sensory information necessary to trigger the fetus expulsion reflex. In fact, neurectomy of the sensory branch of the pelvic nerve induces dystocia in rats.…”

Section: Discussionmentioning

confidence: 99%

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Anatomical organization and somatic axonal components of the lumbosacral nerves in female rabbits

Cruz

Hernández-Plata

Lucio

et al. 2017

Neurourology and Urodynamics

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Most of the sacral spinal nerves of rabbit are mixed, carrying sensory, and motor information. Sacral nerves innervate the hind limbs, pelvic viscera, clitoris, perineal muscles, inguinal and anal glands and perineal, perigenital, and rump skin. The detailed description of the sacral nerves organization, topography, and axonal components further the knowledge of the innervation in pelvic and perinal structures of the female rabbit. This information will be useful in future studies about the physiology and physiopathology of urinary, fecal, reproductive, and sexual functions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anatomical organization and somatic axonal components of the lumbosacral nerves in female rabbits

Cruz

Hernández-Plata

Lucio

et al. 2017

Neurourology and Urodynamics

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show abstract

“…About 60% of the women in the United States of America receive a kind of neuraxial analgesia. However, there is a concern regarding the negative impact of these methods on the delivery and delivery procedure [8]. Although the advantages of using these methods are known, there are controversies regarding their consequences [2].…”

Section: Introductionmentioning

confidence: 99%

Comparison stage of vaginal delivery in painless labor with epidural & spinal analgesia

Kamali¹,

Akbari²,

Afsane³

et al. 2018

Ann Clin Anal Med

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Aim: Aim of this study was comparison stage of vaginal delivery in painless labor with epidural &spinal analgesia. Material and Method: This study was clinical trials and double blind.90 pregnant women in Taleghani hospital entered in this study. We divided women in 3 groups (spinal analgesia, Epidural analgesia, control) randomly. We recorded Heart rate and blood pressure and oxygen saturation in mothers every 15 minutes and fetal heart rate and apgar in one and five minute after delivery and dilatation in cervix every 2 hours for full dilatation. Results: Mean of second stage in delivery in control group was less than others groups (p=0/01).In Epidural and spinal groups were not significant difference (P> 0/05). Discussion: Mean of second delivery in epidural and spinal analgesia decreased.

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“…The introduction of spinal analgesia (epidural and spinal anesthesia, or combination of these two methods) has been one of the most dramatic developments in the control of labor pain, which has been accompanied by maternal satisfaction and the sanctity of the embryo and baby 10 . Currently, approximately 60 % of women in the United States use painless methods 11 . After spinal cord anesthesia, the heart rate may undergo changes such as those associated with bradycardia.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of epidural and spinal anesthesia on analgesia and blood gases in neonates born by natural vaginal delivery: A clinical trial study

et al. 2020

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Introduction: One of the concerns of painless deliveries is the safety of neonates. This clinical trial study aimed to compare the effects of epidural and spinal anesthesia on the mortality rate of neonates. Methods: This clinical trial was conducted in Hamadan Hospital in Iran. Ninety women, ages 18 to 45, were randomly assigned to receive epidural or subdural anesthesia. Using a checklist, the following were collected: demographic information, midwifery, hemodynamic status, mothers' pain intensity, and analyses of the baby's umbilical cord blood. The data were analyzed by SPSS version 16 for statistical analysis. Twenty-two of the patients with spinal anesthesia and epidural anesthesia were excluded from the study. Results: There was no significant difference between the two groups in terms of age, gestational age, parity, and severity of pain before or after anesthesia. The hemodynamic status of the mothers before and during the first postoperative period was in the normal range, except that in the spinal group, a decrease in systolic blood pressure was observed in normal range compared with the epidural anesthesia group. In blood gas analysis, the mean pH, partial pressure of carbon dioxide (PCO2), and bicarbonate (HCO3) did not show significant differences between the two groups (p > 0.05). The only complications were acidosis and epidural anesthesia. Conclusion: Based on the findings of the present study, both spinal and epidural opioids have no adverse effects on the health of neonates. However, both spinal and epidural opioid are preferred due to fewer changes in the hemodynamic changes in mothers and in umbilical cord blood gas.

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Neuraxial analgesia effects on labour progression: facts, fallacies, uncertainties and the future

Cited by 55 publications

References 63 publications

Anatomical organization and somatic axonal components of the lumbosacral nerves in female rabbits

Anatomical organization and somatic axonal components of the lumbosacral nerves in female rabbits

Comparison stage of vaginal delivery in painless labor with epidural & spinal analgesia

Comparison of the effects of epidural and spinal anesthesia on analgesia and blood gases in neonates born by natural vaginal delivery: A clinical trial study

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