Related Experiment Video
Updated: May 7, 2025
03:14
Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
243
Non-neuraxial labour analgesia
Ning Lynn Chen1, Hannah Smyth2, Ban Leong Sng1
1Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore.
Best Practice & Research. Clinical Anaesthesiology
|January 7, 2025
Summary
Epidural analgesia is not always possible for labor pain. This review explores alternative non-neuraxial pain relief methods, including pharmacological and non-pharmacological options, to improve maternal satisfaction.
Area of Science:
- Obstetrics and Gynecology
- Pain Management
- Anesthesiology
Background:
- Epidural analgesia is the standard for labor pain but has limitations.
- Patient choice and medical reasons can preclude epidural use.
- Alternative labor analgesia methods are crucial for diverse patient needs.
Purpose of the Study:
- To review evidence on non-neuraxial labor analgesia alternatives.
- To explore both pharmacological and non-pharmacological options.
- To assess effectiveness and impact on maternal satisfaction.
Main Methods:
- Systematic review of existing literature.
- Analysis of pharmacological labor analgesia (opioids, inhalational agents).
- Evaluation of non-pharmacological methods (continuous support, sterile water injections).
Main Results:
- Non-neuraxial options provide effective labor pain relief.
- Pharmacological methods include opioids and inhalational agents.
- Non-pharmacological techniques like sterile water injections show promise for pain management and satisfaction.
Conclusions:
- Non-neuraxial analgesia offers viable alternatives to epidurals.
- These methods can enhance maternal satisfaction during labor.
- Further research supports diverse pain management strategies in obstetrics.
Keywords:
hydrotherapylabour analgesianitrous oxidenon-neuraxialopioidsremifentanilsterile water injectionsvirtual realityMore Related Videos
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
396
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...
396
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
550
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...
550
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
714
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...
714
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
315
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...
315
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
887
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...
887
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
156
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...
156