A review article on epidural analgesia for labor pain management: A systematic review

Abstract

ABSTRACT Summary: labor pain is described as the most severe pain experienced ever by most women where majority of parturients complained their pain as severe or extremely severe. This stressful condition leads to negative impacts on maternal and fetal physiology. Optimal method of evidence-based management of pain in laboring mothers remains in debate. There is variety of controversial approaches based on different evidences. Therefore, it is important to review recent articles to recommend a relatively safe method that is feasible in our clinical set up to provide appropriate method of labor pain management. The objective of this review was to indicate safer options of labor pain management that help improve maternal care regarding pain management. Methods: Google Scholars, PubMed through HINARI, and other search engines were used to search high quality evidences that help to reach appropriate conclusions. Discussion: Compared with other techniques, Epidural analgesia is acknowledged as the most effective and the gold standard of labor pain management. Even though epidural analgesia was thought to prolong second stage of labor and increase the rate of instrumental delivery, recent studies have proved that duration of labor and incidence of instrumental delivery is comparable between those who receive epidural and parenteral opioids, there was less neonatal depression, better maternal satisfaction and no increased risk of the rate of cesarean section during labor epidural. Conclusion: In the absence of a medical contraindication, maternal request is a sufficient indication for pain relief during labor. The challenge of labor pain management is the choice of the technique. The management should be guided by a thorough evaluation to identify indications and contraindications, and the technique of management should be safe for both the mother and the fetus. Highlights:

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