title: Modern neuraxial labor analgesia: options for initiation, maintenance and drug selection.
abstract: In the present review we outline the state-of-the-art of neuraxial analgesia. As neuraxial analgesia remains the gold standar of analgesia during labor, we review the most recent literature on this topic. The neuraxial analgesia techniques, types of administration, drugs, adjuvants, and adverse effects are investigated from the references. Most authors would agree that central neuraxial analgesia is the best form to manage labor pain. When neuraxial analgesia is administered to the parturient in labor, different management choices must be made by the anesthetist: how will we initiate analgesia, how will analgesia be maintained, which local anesthetic will we use for neuraxial analgesia and which adjuvant drugs will we combine? The present manuscript tries to review the literature to answer these questions.
authors.affiliation: Department of Anesthesiology, University Hospitals Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium. marc.vandevelde@uz.kuleuven.ac.be
authors.forename: M
authors.initials: M
authors.lastname: Van de Velde
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D016058:Analgesia, Patient-Controlled; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000762:Anesthesia Recovery Period; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D001919:Bradycardia / Q000139:chemically induced / Q000196:embryology; D002585:Cesarean Section / Q000706:statistics & numerical data; D002986:Clinical Trials as Topic; D036861:Delivery, Obstetric; D005260:Female; D005318:Fetal Heart / Q000187:drug effects; D020233:Gait Disorders, Neurologic / Q000139:chemically induced; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007263:Infusions, Parenteral; D007278:Injections, Spinal; D015201:Meta-Analysis as Topic; D011247:Pregnancy
chemical_list: D000759:Adjuvants, Anesthesia; D000700:Analgesics; D000779:Anesthetics, Local