title: Neuraxial analgesia effects on labour progression: facts, fallacies, uncertainties and the future.
abstract: Approximately 60% of women who labour in the USA receive some form of neuraxial analgesia, but concerns have been raised regarding whether it negatively impacts the labour and delivery process. In this review, we attempt to clarify what has been established as truths, falsities and uncertainties regarding the effects of this form of pain relief on labour progression, negative and/or positive. Additionally, although the term 'epidural' has become synonymous with neuraxial analgesia, we discuss two other techniques, combined spinal-epidural and continuous spinal analgesia, that are gaining popularity, as well as their effects on labour progression.
authors.affiliation: Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: E N
authors.initials: EN
authors.lastname: Grant
authors.forename: W
authors.initials: W
authors.lastname: Tao
authors.forename: M
authors.initials: M
authors.lastname: Craig
authors.forename: D
authors.initials: D
authors.lastname: McIntire
authors.forename: K
authors.initials: K
authors.lastname: Leveno
mesh_terms: D015360:Analgesia, Epidural / Q000379:methods / Q000639:trends; D016362:Analgesia, Obstetrical / Q000379:methods / Q000639:trends; D036861:Delivery, Obstetric; D004420:Dystocia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D048949:Labor Pain / Q000188:drug therapy*; D007743:Labor, Obstetric / Q000187:drug effects*; D010147:Pain Measurement; D036801:Parturition; D017060:Patient Satisfaction; D011247:Pregnancy; D016896:Treatment Outcome
keywords: Analgesia; epidural; labour; neuraxial
references.citation: Rev Bras Anestesiol. 2007 Feb;57(1):39-51
references.pmid: 19468617
references.citation: Cochrane Database Syst Rev. 2007 Oct 17;(4):CD001063
references.pmid: 17943750
references.citation: Br Med J. 1970 May 2;2(5704):296
references.pmid: 5420187
references.citation: Am J Obstet Gynecol. 1954 Dec;68(6):1568-75
references.pmid: 13207246
references.citation: Anesthesiology. 2003 Apr;98(4):957-63
references.pmid: 12657859
references.citation: Obstet Gynecol. 1955 Dec;6(6):567-89
references.pmid: 13272981
references.citation: Am J Obstet Gynecol. 1983 Sep 1;147(1):13-5
references.pmid: 6614080
references.citation: Anesthesiology. 2008 Feb;108(2):286-98
references.pmid: 18212574
references.citation: Anesth Analg. 2001 Jun;92(6):1524-8
references.pmid: 11375838
references.citation: Obstet Gynecol. 2010 Apr;115(4):705-710
references.pmid: 20308828
references.citation: Cochrane Database Syst Rev. 2011 Dec 07;(12):CD000331
references.pmid: 22161362
references.citation: Cochrane Database Syst Rev. 2007 Jul 18;(3):CD003401
references.pmid: 17636721
references.citation: Am J Obstet Gynecol. 1993 Oct;169(4):851-8
references.pmid: 8238138
references.citation: Acta Anaesthesiol Scand. 1976;20(3):259-68
references.pmid: 961334
references.citation: Obstet Gynecol. 2004 Jul;104(1):213
references.pmid: 15229040
references.citation: Anaesthesia. 1999 Jun;54(6):535-9
references.pmid: 10403865
references.citation: Anesthesiology. 2009 Oct;111(4):871-80
references.pmid: 19741492
references.citation: Clin Obstet Gynecol. 2003 Sep;46(3):633-45
references.pmid: 12972745
references.citation: N Engl J Med. 1997 Dec 11;337(24):1715-9
references.pmid: 9392696
references.citation: Int J Gynaecol Obstet. 2009 Sep;106(3):242-5
references.pmid: 19481203
references.citation: Natl Vital Stat Rep. 2013 Sep;62(3):1-20
references.pmid: 24321416
references.citation: BJOG. 2015 Feb;122(3):344-50
references.pmid: 24849943
references.citation: Br Med J. 1969 May 24;2(5655):477-80
references.pmid: 5771578
references.citation: Anesthesiology. 2001 Oct;95(4):913-20
references.pmid: 11605932
references.citation: Obstet Gynecol Surv. 1948 Oct;3(5):629-46
references.pmid: 18886473
references.citation: Anesthesiology. 1998 Dec;89(6):1336-44
references.pmid: 9856707
references.citation: J Obstet Gynaecol Res. 2011 Nov;37(11):1532-9
references.pmid: 21676079
references.citation: Anesthesiology. 1994 Jun;80(6):1193-200
references.pmid: 8010465
references.citation: Am J Obstet Gynecol. 1978 Nov 1;132(5):495-500
references.pmid: 717451
references.citation: Am J Obstet Gynecol. 2006 Mar;194(3):600-5
references.pmid: 16522386
references.citation: Anesthesiology. 1999 Oct;91(4):920-5
references.pmid: 10519493
references.citation: Obstet Gynecol. 2010 Dec;116(6):1281-1287
references.pmid: 21099592
references.citation: Br Med J. 1976 Oct 16;2(6041):944
references.pmid: 974684
references.citation: Anesthesiology. 1994 Jun;80(6):1201-8
references.pmid: 8010466
references.citation: Int J Obstet Anesth. 1998 Jul;7(3):161-4
references.pmid: 15321209
references.citation: Anesth Analg. 1991 Mar;72(3):275-81
references.pmid: 1994754
references.citation: Obstet Gynecol. 2003 Dec;102(6):1445-54
references.pmid: 14662243
references.citation: Br J Obstet Gynaecol. 1988 Jan;95(1):57-64
references.pmid: 3342209
references.citation: Anesth Analg. 1993 Nov;77(5):919-24
references.pmid: 8214727
references.citation: N Engl J Med. 1998 Jul 9;339(2):76-9
references.pmid: 9654537
references.citation: N Engl J Med. 2005 Feb 17;352(7):655-65
references.pmid: 15716559
references.citation: Am J Physiol. 1974 Mar;226(3):703-10
references.pmid: 4206198
references.citation: Br J Obstet Gynaecol. 1976 Aug;83(8):631-5
references.pmid: 952794
references.citation: Ann Surg. 1944 Aug;120(2):143-51
references.pmid: 17858479
references.citation: Am J Obstet Gynecol. 2004 Jul;191(1):259-65
references.pmid: 15295376
references.citation: Natl Vital Stat Rep. 2011 Apr 6;59(5):1-13, 16
references.pmid: 21553556
references.citation: Br J Obstet Gynaecol. 1985 Dec;92(12):1246-50
references.pmid: 4084468
references.citation: BJOG. 2011 May;118(6):655-61
references.pmid: 21392241
references.citation: Anesthesiology. 2001 Oct;95(4):857-61
references.pmid: 11605924