title: Update on modern neuraxial analgesia in labour: a review of the literature of the last 5 years.
abstract: Several strategies and alternative therapies have been used to provide analgesia for labour pain. Over the last few years, a number of improvements have enhanced the efficacy and safety of neuraxial analgesia and ultimately have improved mothers' satisfaction with their birth experience. As labour analgesia is a field of obstetric anaesthesia that is rapidly evolving, this review is an update, from a clinical point of view, of developments over the last 5-7 years. We discuss advantages and controversies related to combined spinal-epidural analgesia, patient controlled epidural analgesia and the integration of computer systems into analgesic modalities. We also review the recent literature on future clinical and research perspectives including ultrasound guided neuraxial block placement, epidural adjuvants and pharmacogenetics. We finally look at the latest work with regards to epidural analgesia and breastfeeding.
authors.affiliation: Department of Anaesthetics, University College London Hospital, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Loubert
authors.forename: A
authors.initials: A
authors.lastname: Hinova
authors.forename: R
authors.initials: R
authors.lastname: Fernando
mesh_terms: D015360:Analgesia, Epidural / Q000009:adverse effects / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001942:Breast Feeding; D004334:Drug Administration Schedule; D005260:Female; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000209:etiology; D051299:Post-Dural Puncture Headache / Q000209:etiology; D011247:Pregnancy
chemical_list: D000779:Anesthetics, Local