Epidural analgesia: Effects on labor progress and maternal and neonatal outcome

被引:37
|
作者
Leighton, BL [1 ]
Halpern, SH [1 ]
机构
[1] Weill Cornell Med Coll, Dept Anesthesiol, New York, NY USA
关键词
D O I
10.1053/sper.2002.32201
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
The intended and unintended effects of epidural labor analgesia are reviewed. Mothers randomized to epidural rather than parenteral opioid analgesia have better pain relief. Fetal oxygenation is not affected by analgesic method; however, neonates whose mothers received intravenous or intramuscular opioids rather than epidural analgesia require more naloxone and have lower Apgar scores. Epidural analgesia does not affect the rates of cesarean delivery, obstetrically indicated instrumented vaginal delivery, neonatal sepsis, or new-onset back pain. Epidural analgesia is associated with longer second labor stages, more frequent oxytocin augmentation, and maternal fever (particularly among women who shiver and women receiving epidural analgesia for > 5 hours) but not with longer first labor stages. Epidural analgesia has no affect but intrapartum opioids decrease lactation success. Epidural use and urinary incontinence are weakly, but probably not causally, associated. Epidural labor analgesia would improve if the mechanisms of these unintended effects could be determined.
引用
收藏
页码:122 / 135
页数:14
相关论文
共 50 条
  • [41] Epidural analgesia during labor and maternal fever
    Philip, J
    Alexander, JM
    Sharma, SK
    Leveno, KJ
    McIntire, DD
    Wiley, J
    ANESTHESIOLOGY, 1999, 90 (05) : 1271 - 1275
  • [42] The effects of meperidine and epidural analgesia in labor on maternal heart rate variability
    Weissman, A.
    Torkhov, O.
    Weissman, A. I.
    Drugan, A.
    INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, 2009, 18 (02) : 118 - 124
  • [43] Positional effects on maternal cardiac output during labor with epidural analgesia
    DanilenkoDixon, DR
    Tefft, L
    Cohen, RA
    Haydon, B
    Carpenter, MW
    AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1996, 175 (04) : 867 - 872
  • [44] MATERNAL ANALGESIA AND NEONATAL EFFECTS OF EPIDURAL SUFENTANIL FOR CESAREAN-SECTION
    CAPOGNA, G
    CELLENO, D
    TOMASSETTI, M
    REGIONAL ANESTHESIA, 1989, 14 (06) : 282 - 287
  • [45] Progress of labor and obstetric outcome in parturients with combined spinal-epidural analgesia for labor: A comparative study
    Shivanagappa, Mamatha
    Kumararadhya, Girish
    Thammaiah, Srinivas
    Swamy, Akshay
    Suhas, Nagashree
    ANNALS OF AFRICAN MEDICINE, 2021, 20 (04) : 270 - 275
  • [46] The impact of epidural analgesia on induced labor outcome
    Ozcan, Tulin
    Edell, Ken
    Jason, Roy
    Glantz, Chris
    Pressman, Eva
    AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2006, 195 (06) : S120 - S120
  • [47] MATERNAL HYPOXEMIA DURING LABOR AND DELIVERY - THE INFLUENCE OF ANALGESIA AND EFFECT ON NEONATAL OUTCOME
    GRIFFIN, RP
    REYNOLDS, F
    ANAESTHESIA, 1995, 50 (02) : 151 - 156
  • [48] MATERNAL AND PERINATAL OUTCOME WITH LABOR ANALGESIA
    Castillo Casiano, Fidel Carlos
    Rojas Martinez, Freddy
    Eduardo Danz Del Pozo, Javier
    REVISTA PERUANA DE GINECOLOGIA Y OBSTETRICIA, 2015, 61 (04): : 363 - 368
  • [49] EPIDURAL BLOCK AND THE PROGRESS AND OUTCOME OF LABOR
    READ, MD
    HUNT, LP
    ANDERTON, JM
    LIEBERMAN, BA
    JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1983, 4 (01) : 35 - 39
  • [50] Epidural analgesia, intrapertum fever, and neonatal outcome
    Wisborg, K.
    Hansen, A. K.
    Uldbjerg, N.
    Henriksen, T. B.
    ACTA PAEDIATRICA, 2007, 96 : 199 - 200