Promising non-narcotic analgesic techniques for labour

被引:6
作者
Mercier, FJ
Benhamou, D
机构
[1] Hop Antoine Beclere, Dept Anaesthesia, Dept Anesthesie Reanimat, F-92141 Clamart, France
[2] Hop Antoine Beclere, Dept Anesthesie Reanimat, Unit Obstet Anaesthesia, F-92141 Clamart, France
来源
BAILLIERES CLINICAL OBSTETRICS AND GYNAECOLOGY | 1998年 / 12卷 / 03期
关键词
anaesthesia; obstetrics; analgesia; labour; alpha(2)-adrenergic agonists; cholinesterase inhibitors; N-methyl-D-aspartate antagonists; benzodiazepines; opioids;
D O I
10.1016/S0950-3552(98)80074-6
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Epidural analgesia and spinal analgesia are the most effective techniques for relieving labour pain. Basically, local anaesthetics (i.e. bupivacaine) and opioids (i.e. fentanyl or sufentanil), especially when combined, produce excellent analgesia with minimal motor blockade. However, none of these agents is devoid of side-effects and analgesia remains sometimes imperfect, suggesting that new drugs would be welcome. Adrenalin and clonidine act on a(2)-adrenoceptors in the spinal cord and both have been found to improve analgesia. These two drugs have already been used in many patients and studies because the absence of neurotoxicity has been well documented. Clonidine looks more attractive, although sedation and hypotension limit its use. Other analgesic drugs are promising alternatives but are still at an experimental or very early clinical stage. Neostigmine and ketamine (without preservative) are not neurotoxic while midazolam neurotoxicity is still controversial. Intravenous remifentanil might prove useful when neuraxial analgesia is contraindicated.
引用
收藏
页码:397 / 407
页数:11
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