Poole Judith H
Presbyterian Healthcare, Charlotte, NC 28226, USA.
J Obstet Gynecol Neonatal Nurs. 2003 Nov-Dec;32(6):780-93. doi: 10.1177/0884217503258498.
Labor and birth, although viewed as a normal physiological process, can produce significant pain, requiring appropriate pain management. Systemic analgesia and regional analgesia/anesthesia have become less common, whereas the use of newer neuraxial techniques, with minimal motor blockade, have become more popular. Low- and ultra-low-dose epidural analgesia, spinal analgesia, and combination spinal-epidural analgesia have replaced the once traditional epidural for labor. The shift from regional anesthesia during labor, in which the woman became a passive participant during the labor and birth, to a collaborative approach for pain management, in which the woman becomes an active participant, has resulted in a new philosophy of labor analgesia. This article provides a review of the current systemic analgesics and regional and neuraxial analgesia/anesthesia techniques for pain management in labor and birth. Also addressed are implications for perinatal nurses who participate in pain management choices during labor and birth.
分娩虽然被视为一个正常的生理过程，但会产生剧痛，需要进行适当的疼痛管理。全身镇痛和区域镇痛/麻醉的使用已不那么常见，而运动阻滞最小的新型神经轴技术的应用则更为普遍。低剂量和超低剂量硬膜外镇痛、脊髓镇痛以及腰麻-硬膜外联合镇痛已取代了曾经用于分娩的传统硬膜外麻醉。分娩镇痛方式从过去产妇在分娩过程中处于被动状态的区域麻醉，转变为产妇成为积极参与者的协作式疼痛管理方法，这带来了一种新的分娩镇痛理念。本文综述了目前用于分娩疼痛管理的全身镇痛药以及区域和神经轴镇痛/麻醉技术。文中还讨论了对在分娩过程中参与疼痛管理选择的围产期护士的影响。
