Strategies to reduce neuraxial analgesia failure during labour

详细信息    查看全文

• 作者：Jocelyn Ong ^{jocelyn.ong.s.y@singhealth.com.sg" class="auth_mail" title="E-mail the corresponding author} ; Dinoo Kirthinanda ^{dinoo.sn@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Samuel Kent Neng Loh ^{sam_kent_loh@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Ban Leong Sng ; ^{sng.ban.leong@singhealth.com.sg" class="auth_mail" title="E-mail the corresponding author} ; ^{blsngdr@yahoo.com.sg" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Epidural analgesia ; Labour pain ; Breakthrough pain
• 刊名：Trends in Anaesthesia and Critical Care
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：7-8
• 期：Complete
• 页码：41-46
• 全文大小：275 K

文摘

Labour neuraxial analgesia failure may lead to inadequate pain relief and patient dissatisfaction. This may occur due to difficulty in epidural placement during the initiation of, or during the maintenance of epidural analgesia. In this review, we investigate the risk factors associated with labour neuraxial analgesia failure and present the recent evidence to improve epidural space identification. Demographic and anaesthetic factors that may increase breakthrough pain are discussed. We also examine the effect of different regimens of local anaesthetic agents and analgesic adjuvants on the quality of analgesia. The use of patient controlled epidural analgesia and novel epidural delivery systems such as the role of intermittent epidural automated boluses are explored.