Analgesics Epidural Overview and Procedure Benefits & Risks of Epidurals Labor With an Epidural Review and conclusion Recent studies investigating the management of analgesia in childbirth have demonstrated that pain relief can be started early in labor with no negative consequences. Also of particular importance are studies showing that automated delivery of large boluses of diluted local anesthetic with opioids might be more effective than continuous background infusion of these drugs in patient-controlled epidural analgesia.
The goal of this brief review is to guide providers of obstetric anesthesia towards an understanding of how these new findings can improve their clinical practice. Research has provided new insights into the mechanisms and management of analgesia in labor and has shed more light on the timing of epidural labor analgesia, the choice of local anesthetics, the pharmacogenetics of opioids, and the use of spinal microcatheters, ultrasound technology, and programmed boluses with PCEA.
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