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Updated: Oct 23, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Update on Non-neuraxial Labor Analgesia
Dana Karol1, Carolyn F Weiniger1
1Division of Anesthesia and Critical Care and Pain, Tel Aviv Sourasky Medical Center, 6 Weizmann St, Tel Aviv, Israel.
Purpose Of Review:
This review will present recent updates for the use of non-neuraxial analgesia for laboring women.
Recent Findings:
Non-neuraxial labor analgesia by nitrous oxide and intravenous opioids are described, and safety concerns with regard to remifentanil administration have been a major focus of recent studies. Fentanyl and nitrous oxide offer some efficacy, albeit less than remifentanil, however with a greater safety margin.
Summary:
Women may request or require alternatives to neuraxial labor analgesia, in some cases due to concurrent comorbidities. Remifentanil offers the most efficacious alternative analgesia option; however, safety concerns may preclude widespread use.
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