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Obstetric analgesia – update 2016

  • Michael Heesen EMAIL logo and Markus Klimek
Published/Copyright: July 7, 2016

Abstract

Neuraxial labor analgesia can be initiated via combined spinal-epidural (CSE) or stand-alone epidural. Pros and cons of these techniques are outlined in this review. In recent years computer-integrated patient-controlled epidural analgesia (CI-PCEA) and programed intermittent epidural boluses (PIEB) have been developed, adding to continuous infusion and PCEA for the maintenance of neuraxial analgesia. Postdural puncture headache (PDPH) and fever can occur secondary to labor epidural that both have clinical relevance for the care givers. Insights into the mechanism of epidural fever and treatment strategies for PDPH are outlined. Due to the increase in obesity the specific considerations for this patient group are discussed. New data have been presented for remifentanil, an ultra-shortly acting opioid, that is used in obstetric analgesia. Without breaking new data, the use of nitrous oxide especially by midwives has a kind of renaissance, and this will be discussed, too.

References

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  1. The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2016-4-4
Accepted: 2016-6-3
Published Online: 2016-7-7
Published in Print: 2017-4-1

©2017 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Intrapartum care
  4. Recommendation and Guidelines for Perinatal Practice
  5. Delivery modes in case of fetal malformations
  6. Review article
  7. Obstetric analgesia – update 2016
  8. Highlight articles
  9. Risk factors and outcomes in “well-selected” vaginal breech deliveries: a retrospective observational study
  10. Induction of labor in breech presentation at term: a retrospective cohort study
  11. Evaluating fetal head dimension changes during labor using open magnetic resonance imaging
  12. Risk factors of uterine rupture with a special interest to uterine fundal pressure
  13. Diagnostic accuracy of fetal scalp lactate for intrapartum acidosis compared with scalp pH
  14. Reference values for Lactate Pro 2™ in fetal blood sampling during labor: a cross-sectional study
  15. Linear and non-linear analysis of uterine contraction signals obtained with tocodynamometry in prediction of operative vaginal delivery
  16. Evaluation of simparteam – a needs-orientated team training format for obstetrics and neonatology
  17. Transient fetal blood redistribution associated with maternal supine position
  18. Original articles
  19. Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States
  20. Fourfold increase in prevalence of gestational diabetes mellitus after adoption of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria
  21. Hematological changes in severe early onset growth-restricted fetuses with absent and reversed end-diastolic flow in the umbilical artery
  22. Breast milk feeding in infants with inherited metabolic disorders other than phenylketonuria – a 10-year single-center experience
  23. Clinical significance of a false positive glucose challenge test in patients with a high body mass index
  24. Obituary
  25. Obituary – Edward Ogata (1945–2017)
  26. Congress Calendar
  27. Congress Calendar
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