Department of Anaesthesiology, University Clinical Center, Medical University of Silesia in Katowice, Poland.
Clinic of Gynecology, Obstetrics and Gynecological Oncology, Department of Heath Science in Katowice, Medical University of Silesia, Katowice, Poland.
Ginekol Pol. 2021;92(10):735-740. doi: 10.5603/GP.a2021.0062.
Labor pain is not only an unpleasant mental experience, but one of the most important factors that may negatively affect the course of labor and the well-being of the fetus. Over the years, many techniques for relieving labor pain have been developed, ranging from non-pharmacological (acupuncture, TENS, hypnosis...), through opioids and aeriform anesthetics, to regional analgesia techniques. Numerous studies and meta-analyzes prove that central blockades are the gold standard of labor analgesia and debunk the myths that these blockages are negatively limited to the course of labor. In the light of recent studies, the claim that epidural analgesia increases the risk of termination by caesarean section should be rejected. It has also been proven that central blockades do not lower the child's APGAR score. Feeling, an indication to use a central block during labor, should be a subjective intolerance to pain and the wishes of the mother in labor. The review presents the directions of development and the current state of knowledge of modern medicine regarding various anesthesia techniques, their safety for the mother, fetus and newborn, as well as practical tips to increase the satisfaction of the mother in labor.
分娩疼痛不仅是一种不愉快的精神体验,还是可能对分娩过程和胎儿健康产生负面影响的最重要因素之一。多年来,已经开发出许多缓解分娩疼痛的技术,从非药物性(针灸、TENS、催眠……)到阿片类药物和气态麻醉剂,再到区域镇痛技术。大量的研究和荟萃分析证明,中枢阻滞是分娩镇痛的金标准,并推翻了这些阻滞对分娩过程有负面影响的神话。根据最近的研究,硬膜外镇痛会增加剖腹产风险的说法应该被拒绝。此外,还证明了中枢阻滞不会降低婴儿的 APGAR 评分。感觉,即分娩时使用中枢阻滞的指征,应该是对疼痛的主观不耐受以及产妇的意愿。该综述介绍了现代医学中各种麻醉技术的发展方向和当前知识状况,以及它们对母亲、胎儿和新生儿的安全性,以及增加产妇满意度的实用技巧。