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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Analgesia and Pain Management01:25

Analgesia and Pain Management

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

Local Anesthetics: Differential Sensitivity of Nerve Fibers

1.3K
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

1.2K
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
1.2K
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

1.0K
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
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Updated: Dec 30, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
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Advances in labor analgesia.

Cynthia A Wong1

  • 1Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

International Journal of Women'S Health
|November 13, 2010
PubMed
Summary

Childbirth pain management options include nonpharmacologic methods and neuraxial analgesia. Neuraxial labor analgesia, such as epidurals, offers the most effective pain relief during childbirth.

Area of Science:

  • Obstetrics
  • Anesthesiology
  • Pain Management

Background:

  • Childbirth involves severe pain, originating from cervical dilation and fetal descent.
  • Current labor analgesia employs regional nerve blocks, systemic analgesics, and nonpharmacologic techniques.
  • Effectiveness of nonpharmacologic methods often lacks rigorous scientific validation.

Purpose of the Study:

  • To review current methods for labor analgesia.
  • To highlight the efficacy and safety of neuraxial labor analgesia.
  • To discuss the components and potential risks of neuraxial techniques.

Main Methods:

  • Review of existing literature on labor analgesia techniques.
  • Analysis of the effectiveness of nonpharmacologic and pharmacologic interventions.
Keywords:
childbirth painepidural analgesialabor analgesianeuraxial analgesia

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  • Examination of neuraxial analgesia, including epidural and spinal-epidural methods.

    • Main Results:

    • Continuous labor support can reduce pharmacologic analgesia use and labor duration.
    • Intradermal water injections show efficacy in alleviating back labor pain.
    • Neuraxial labor analgesia is the most effective pain relief method, avoiding maternal or fetal sedation.

    Conclusions:

    • Neuraxial analgesia, typically combining local anesthetics and opioids, provides superior pain relief during childbirth.
    • This method does not elevate cesarean delivery rates compared to systemic opioids.
    • Dense neuraxial analgesia might be associated with an increased risk of instrumental vaginal delivery.