Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview
Abstract Labor analgesia is increasingly widespread throughout the world with a rate ranging from 10 to 60%. The benefits regarding clinical and non-clinical maternal–fetal outcomes are currently discussed in international scientific literature. Even stage of labor needs a different and appropriate...
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2025-01-01
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| Series: | Journal of Anesthesia, Analgesia and Critical Care |
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| Online Access: | https://doi.org/10.1186/s44158-025-00224-3 |
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| author | Antonio Coviello Carmine Iacovazzo Maria Grazia Frigo Marilena Ianniello Dario Cirillo Giuseppe Tierno Andrea Uriel de Siena Pasquale Buonanno Giuseppe Servillo |
| author_facet | Antonio Coviello Carmine Iacovazzo Maria Grazia Frigo Marilena Ianniello Dario Cirillo Giuseppe Tierno Andrea Uriel de Siena Pasquale Buonanno Giuseppe Servillo |
| author_sort | Antonio Coviello |
| collection | DOAJ |
| description | Abstract Labor analgesia is increasingly widespread throughout the world with a rate ranging from 10 to 60%. The benefits regarding clinical and non-clinical maternal–fetal outcomes are currently discussed in international scientific literature. Even stage of labor needs a different and appropriate approach to control the pain; however, different techniques are reported in literature. The following study intends to give a brief overview of the characteristics of the different neuraxial and non-neuraxial techniques currently available and the non-technical skills necessary for effective assistance to pregnant women, providing insights on the topic to understand critical issues at the same time. After bibliographic research since 2018 to 2023, many randomized controlled trials, literature reviews, systematic reviews, and metanalysis were evaluated to create this brief overview. The following pharmacological and non-pharmacological approaches were assessed: spinal techniques, such as epidural analgesia (EA), combined spinal-epidural (CSE), dural puncture epidural (DPE), and continuous spinal anesthesia (CSA); pharmacological administration of nitrous oxide (N2O) and systemic opioids (morphine, fentanyl, and pethidine); as the third one transcutaneous electric nerve stimulation (TENS), acupressure/acupuncture, aromatherapy, and breathing exercises. All the assessed approaches are relatively safe and effective, but the association of technical and non-technical skills is needed to improve the maternal and fetus outcome. More studies are needed to clarify what is the best approach to labor analgesia. |
| format | Article |
| id | doaj-art-d589b387678a4019bbacf35a2e449851 |
| institution | Kabale University |
| issn | 2731-3786 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Anesthesia, Analgesia and Critical Care |
| spelling | doaj-art-d589b387678a4019bbacf35a2e4498512025-02-02T12:47:26ZengBMCJournal of Anesthesia, Analgesia and Critical Care2731-37862025-01-015111210.1186/s44158-025-00224-3Technical aspects of neuraxial analgesia during labor and maternity care: an updated overviewAntonio Coviello0Carmine Iacovazzo1Maria Grazia Frigo2Marilena Ianniello3Dario Cirillo4Giuseppe Tierno5Andrea Uriel de Siena6Pasquale Buonanno7Giuseppe Servillo8Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”UOSD, Obstetric Anesthesia and ResuscitationDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”Abstract Labor analgesia is increasingly widespread throughout the world with a rate ranging from 10 to 60%. The benefits regarding clinical and non-clinical maternal–fetal outcomes are currently discussed in international scientific literature. Even stage of labor needs a different and appropriate approach to control the pain; however, different techniques are reported in literature. The following study intends to give a brief overview of the characteristics of the different neuraxial and non-neuraxial techniques currently available and the non-technical skills necessary for effective assistance to pregnant women, providing insights on the topic to understand critical issues at the same time. After bibliographic research since 2018 to 2023, many randomized controlled trials, literature reviews, systematic reviews, and metanalysis were evaluated to create this brief overview. The following pharmacological and non-pharmacological approaches were assessed: spinal techniques, such as epidural analgesia (EA), combined spinal-epidural (CSE), dural puncture epidural (DPE), and continuous spinal anesthesia (CSA); pharmacological administration of nitrous oxide (N2O) and systemic opioids (morphine, fentanyl, and pethidine); as the third one transcutaneous electric nerve stimulation (TENS), acupressure/acupuncture, aromatherapy, and breathing exercises. All the assessed approaches are relatively safe and effective, but the association of technical and non-technical skills is needed to improve the maternal and fetus outcome. More studies are needed to clarify what is the best approach to labor analgesia.https://doi.org/10.1186/s44158-025-00224-3Epidural analgesiaLabor analgesiaMaternal–fetal safetyLabor pain |
| spellingShingle | Antonio Coviello Carmine Iacovazzo Maria Grazia Frigo Marilena Ianniello Dario Cirillo Giuseppe Tierno Andrea Uriel de Siena Pasquale Buonanno Giuseppe Servillo Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview Journal of Anesthesia, Analgesia and Critical Care Epidural analgesia Labor analgesia Maternal–fetal safety Labor pain |
| title | Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview |
| title_full | Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview |
| title_fullStr | Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview |
| title_full_unstemmed | Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview |
| title_short | Technical aspects of neuraxial analgesia during labor and maternity care: an updated overview |
| title_sort | technical aspects of neuraxial analgesia during labor and maternity care an updated overview |
| topic | Epidural analgesia Labor analgesia Maternal–fetal safety Labor pain |
| url | https://doi.org/10.1186/s44158-025-00224-3 |
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