Abstract
Pain is a common and treatable symptom in all stages of pregnancy. All agents must
be prescribed considering the perceived benefits whilst acknowledging the potential
fetal adverse effects. Oral agents can be used safely and effectively during the antenatal
period, and management must be tailored for each individual. Intrapartum analgesia
should be multi-modal with consideration for complimentary therapies including continuous
labour support and water immersion. Epidural anaesthesia is the gold standard for
pain management in labour, with inhalation anaesthetic offering excellent adjunct
analgesia. A combined spinal/epidural anaesthesia acts rapidly compared to traditional
epidural. Pudendal nerve blocks are effective methods of analgesia with decreasing
popularity. Transversus abdominis plane blocks and wound infiltration of local anaesthetic
reduces post-operative requirement for opioids. The obstetric anaesthetist plays a
significant role in the multidisciplinary team in identifying and planning care for
high-risk individuals. Furthermore, anaesthetic intervention at the time of delivery
is not infrequent and can be optimized.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Obstetrics, Gynaecology and Reproductive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Further reading
- Antenatal and postnatal analgesia: scientific impact paper No. 59.BJOG An Int J Obstet Gynaecol. 2018; 126: e114-e124https://doi.org/10.1111/1471-0528.15510
- Major complications of central neuraxial blocks: the 3rd national audit project of the royal college of anaesthetists.Nat Audit Project. 2009; https://doi.org/10.1097/01.sa.0000351785.16340.96
- Pain management for women in labour: an overview of systematic reviews (Review).Cochrane Database Syst Rev. 2012; https://doi.org/10.1002/14651858.CD009234.pub2
- Findings, conclusions and essential actions from the independent review of maternity services.2022
UK Teratology Information Service Best use of medicines in pregnancy (BUMPs). Available at: https://www.medicinesinpregnancy.org/bumps/Medicine–pregnancy.
Article info
Publication history
Published online: December 16, 2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
