Update on epidural analgesia for labor.

Authors

  • Belén Sánchez Quirós Resident doctor. Anesthesia and Resuscitation. University Clinical Hospital of Valladolid, Spain
  • Rocio López Herrero Resident doctor. Anesthesia and Resuscitation. University Clinical Hospital of Valladolid, Spain
  • Francisco Javier Lomo Montero Specialist Physician in the Area of Anesthesiology, Resuscitation and Intensive Care.Valladolid University Clinical Hospital, Spain.

DOI:

https://doi.org/10.30445/rear.v13i12.933

Keywords:

bolo epidural intermitente, infusion epidural continua, analgesia epidural controlada por el paciente, patient-controlled epidural analgesia, continuous epidural infusion, programmed intermittent epidural bolus

Abstract

The pain of labor produces not only emotional suffering but also physiological alterations that affect the mother and the fetus such as: hyperventilation, severe respiratory alkalosis, increased catecholamines and stress hormones, fetal-placental hypoxia and fetal acidosis and psychological alterations and stress post-traumatic.

Currently, neuraxial anesthesia and more specifically epidural analgesia is the main recommendation as a pharmacological method of analgesia in labor. We have mainly focused on two methods of infusion. On the one hand, the traditional, continuous epidural infusion (CEI) plus patient-controlled epidural analgesia (PCEA) and on the other; programmed intermittent epidural bolus (PIEB) which is a method of infusing drugs into the epidural space that consists of the administration of fixed boluses at determined intervals.

References

(1)Actualización de los protocolos asistenciales de la Sección de Anestesia Obstétrica de la SEDAR. 2ª Edición. 2016

(2) Arendt, Katherine W. MD The 2015 Gerard W. Ostheimer Lecture: What’s New in Labor Analgesia and Cesarean Delivery, Anesthesia & Analgesia: May 2016 - Volume 122 - Issue 5 - p 1524-1531 doi: 10.1213/ANE.0000000000001265

(3) Wong CA, Ratliff JT, Sullivan JT, Scavone BM, Toledo P, McCarthy RJ. A randomized comparison of programmed intermittent epidural bolus with continuous epidural infusion for labor analgesia. Anesth Analg. 2006;102(3):904-909. doi:10.1213/01.ane.0000197778.57615.1a

(4) Fettes PD, Moore CS, Whiteside JB, McLeod GA, Wildsmith JA. Intermittent vs continuous administration of epidural ropivacaine with fentanyl for analgesia during labour. Br J Anaesth. 2006;97(3):359-364. doi:10.1093/bja/ael157

(5) Capogna G, Stirparo S. Techniques for the maintenance of epidural labor analgesia. Curr Opin Anaesthesiol. 2013;26(3):261-267. doi:10.1097/ACO.0b013e328360b069

(6) Wong CA, McCarthy RJ, Hewlett B. The effect of manipulation of the programmed intermittent bolus time interval and injection volume on total drug use for labor epidural analgesia: a randomized controlled trial. Anesth Analg. 2011;112(4):904-911. doi:10.1213/ANE.0b013e31820e7c2f

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Published

2022-01-03

How to Cite

Sánchez Quirós, B., López Herrero, R. ., & Lomo Montero, F. J. (2022). Update on epidural analgesia for labor. Revista Electrónica AnestesiaR, 13(12). https://doi.org/10.30445/rear.v13i12.933

Issue

Vol. 13 No. 12 (2021): Revista Electrónica de AnestesiaR

Section

Critical reviews of articles

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Copyright (c) 2022 Revista Electrónica AnestesiaR

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