| REVIEW ARTICLE |
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| Year : 2014 | Volume
: 28
| Issue : 2 | Page : 71-81 |
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Labor epidural analgesia: Past, present and future
Reena, Kasturi H. Bandyopadhyay, Mumtaz Afzal, Amiya K. Mishra, Abhijit Paul
Department of Anaesthesiology, Perioperative Care and Pain Services, Medica Superspeciality Hospital, Mukundapur, Kolkata, West Bengal, India
Correspondence Address:
Abhijit Paul
Department of Anaesthesiology, Perioperative Care and Pain Services, Medica Superspeciality Hospital, 127 Mukundapur, EM Bypass, Kolkata-700 099, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-5333.132843
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One of the most severe pains experienced by a woman is that of childbirth. Providing analgesia for labor has always been a challenge more so because of the myths and controversies surrounding labor. It is imperative to understand the pain transmission during various stages of labor in order to select a proper technique for providing labor analgesia. The adverse effects of labor pain are numerous and affect both the mother as well as the fetus. Currently lumbar epidural is considered to be the gold standard technique for labor analgesia. Local anaesthetics like bupivacaine and ropivacaine are commonly used and adjuvants like clonidine, fentanyl and neostigmine have been extensively studied. However, despite being so popular, epidural analgesia is not without complications, with hypotension being the most common. Other complications include accidental dural puncture, infection, intravascular placement, high block and epidural hematoma. Other neuraxial techniques include continuous caudal analgesia, and combined spinal epidural analgesia. The numerous studies investigating the various aspects of this method have also served to dispel various myths surrounding epidural analgesia like increased incidence of cesarean section and instrumental delivery, prolongation of labor and future back pain. The future of labor analgesia lies in the incorporation of ultrasound in identifying the epidural space helping in proper catheter placement. The keywords "labor epidural" in the PUBMED revealed a total of 5018 articles with 574 review articles and 969 clinical trials. The relevant articles along with their references were extensively studied. |
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