Related Experiment Video
Updated: Apr 15, 2026
03:14
Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
2.1K
Modern neuraxial labour analgesia
Ban L Sng1, Sarah C Kwok, Alex T H Sia
1aDepartment of Women's Anaesthesia, KK Women's and Children's Hospital bDuke-NUS Graduate Medical School, Singapore.
Current Opinion in Anaesthesiology
|April 2, 2015
Summary
Recent advances in epidural analgesia, including patient-controlled epidural analgesia and automated bolus techniques, optimize labor pain relief. These innovations aim to improve safety, efficacy, and patient satisfaction during childbirth.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Pain Management
Background:
- Neuraxial analgesia is the gold standard for labor pain relief.
- Effective pain management during childbirth is crucial for maternal experience.
Purpose of the Study:
- To explore recent advancements in initiating and maintaining epidural analgesia.
- To evaluate how new technologies enhance the birthing experience.
Main Methods:
- Review of current literature on epidural analgesia techniques.
- Analysis of patient-controlled epidural analgesia (PCEA) and automated bolus systems.
- Examination of pump technology and delivery systems.
Main Results:
- Patient-controlled epidural analgesia (PCEA) and computer-integrated PCEA allow individualized titration.
- Intermittent epidural bolus techniques (programmed intermittent bolus, automated mandatory bolus) optimize analgesia.
- Research focuses on optimal dosing, intervals, and frequency for improved safety and efficacy.
Conclusions:
- Recent developments in pump technology and epidural delivery systems enhance maternal birthing experiences.
- Individualized titration and optimization of labor analgesia are key to improving outcomes.
- The focus is on enhancing safety, efficacy, and patient satisfaction in labor analgesia.
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
1.0K
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...
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...
1.0K
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
2.0K
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...
2.0K
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
1.7K
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...
1.7K
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
2.1K
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...
One of the advantages of...
2.1K
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
2.7K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
2.7K
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
1.5K
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...
1.5K