Sodha Serena, Reeve Alexandra, Fernando Roshan
Obstetric Anaesthesia Research Fellow, Department of Anesthesia, University College Hospital, London, UK.
Consultant, Department of Anesthesia, University College Hospital, London, UK.
Pain Manag. 2017 Sep;7(5):419-426. doi: 10.2217/pmt-2017-0010. Epub 2017 Sep 22.
Numerous techniques are in use to provide analgesia for labor, of which central neuraxial block is widely considered superior to non-neuraxial options. Central neuraxial techniques have evolved over many years to provide greater efficacy, safety and maternal satisfaction. This narrative review focuses on the literature relating to central neuraxial labor analgesia from the past 5 years, from November 2010 to October 2015. We discuss the evidence related to the various central neuraxial techniques used, the increasingly widespread use of ultrasound guidance and the evidence surrounding other novel methods of central neuraxial block insertion. The timing of institution of central neuraxial analgesia in labor is considered, as are the advances in maintenance regimens for labor analgesia.
目前有多种技术用于分娩镇痛,其中中枢神经轴索阻滞被广泛认为优于非神经轴索阻滞方法。中枢神经轴索技术经过多年发展,已具备更高的疗效、安全性及产妇满意度。本叙述性综述聚焦于2010年11月至2015年10月这过去5年中与中枢神经轴索分娩镇痛相关的文献。我们讨论了与所使用的各种中枢神经轴索技术相关的证据、超声引导使用的日益广泛以及围绕中枢神经轴索阻滞置入其他新方法的证据。同时还考虑了分娩时中枢神经轴索镇痛开始的时机以及分娩镇痛维持方案的进展。