Acta clinica Croatica, Vol. 54. No. 3., 2015.
Review article
Epidural Analgesia in Labor - Controversies
Nada Bilić
; Department of Anesthesiology and ICU, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ivka Djaković
; Clinical Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Katarina Kličan-Jaić
; Department of Anesthesiology and ICU, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Senka Sabolović Rudman
; Clinical Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Željko Ivanec
; Department of Anesthesiology and ICU, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Abstract
Labor pain is one of the most severe pains. Labor is a complex and individual process with varying maternal requesting analgesia. Labor analgesia must be safe and accompanied by minimal amount of unwanted consequences for both the mother and the child, as well as for the delivery procedure. Epidural analgesia is the treatment that best meets these demands. According to the American Congress of Obstetrics and Gynecology and American Society of Anesthesiologists, mother’s demand is a reason enough for the introduction of epidural analgesia in labor, providing that no contraindications exist. The application of analgesics should not cease at the end of the second stage of labor, but it is recommended that lower concentration analgesics be then applied. Based on the latest studies, it can be claimed that epidural analgesia can be applied during the major part of the first and second stage of labor. According to previous investigations, there is no definitive conclusion about the incidence of instrumental delivery, duration of second stage of labor, time of epidural analgesia initiation, and long term outcomes for the newborn. Cooperation of obstetric and anesthesiology personnel, as well as appropriate technical equipment significantly decrease the need of instrumental completion of a delivery, as well as other complications encountered in the application of epidural analgesia. Our hospital offers 24/7 epidural analgesia service. The majority of pregnant women in our hospital were aware of the advantages of epidural analgesia for labor, however, only a small proportion of them used it, mainly because of inadequate level of information.
Keywords
Analgesia, epidural – utilization; Labor pain; Analgesia, epidural – contraindications; Labor onset; Delivery, obstetric – instrumentation; Labor stages
Hrčak ID:
148912
URI
Publication date:
1.11.2015.
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