Actualización en analgesia epidural para el trabajo de parto.
- Sánchez Quirós, Belén 1
- López Herrero, Rocio
- Lomo Montero, Francisco Javier 2
- 1 MIR Anestesiología y Reanimación. Hospital Clínico Universitario de Valladolid
- 2 FEA Anestesiología y Reanimación Hospital Clínico Universitario de Valladolid
ISSN: 1989-4090
Datum der Publikation: 2021
Titel der Ausgabe: Revista Electrónica de AnestesiaR
Ausgabe: 13
Nummer: 12
Art: Artikel
Andere Publikationen in: Revista electrónica AnestesiaR
Zusammenfassung
The pain of labor produces not only emotional suffering but also physiological alterations that affect the mother and the fetus such as: hyperventilation, severe respiratory alkalosis, increased catecholamines and stress hormones, fetal-placental hypoxia and fetal acidosis and psychological alterations and stress post-traumatic. Currently, neuraxial anesthesia and more specifically epidural analgesia is the main recommendation as a pharmacological method of analgesia in labor. We have mainly focused on two methods of infusion. On the one hand, the traditional, continuous epidural infusion (CEI) plus patient-controlled epidural analgesia (PCEA) and on the other; programmed intermittent epidural bolus (PIEB) which is a method of infusing drugs into the epidural space that consists of the administration of fixed boluses at determined intervals.
Bibliographische Referenzen
- (1)Actualización de los protocolos asistenciales de la Sección de Anestesia Obstétrica de la SEDAR. 2ª Edición. 2016
- (2) Arendt, Katherine W. MD The 2015 Gerard W. Ostheimer Lecture: What’s New in Labor Analgesia and Cesarean Delivery, Anesthesia & Analgesia: May 2016 - Volume 122 - Issue 5 - p 1524-1531 doi: 10.1213/ANE.0000000000001265
- (3) Wong CA, Ratliff JT, Sullivan JT, Scavone BM, Toledo P, McCarthy RJ. A randomized comparison of programmed intermittent epidural bolus with continuous epidural infusion for labor analgesia. Anesth Analg. 2006;102(3):904-909. doi:10.1213/01.ane.0000197778.57615.1a
- (4) Fettes PD, Moore CS, Whiteside JB, McLeod GA, Wildsmith JA. Intermittent vs continuous administration of epidural ropivacaine with fentanyl for analgesia during labour. Br J Anaesth. 2006;97(3):359-364. doi:10.1093/bja/ael157
- (5) Capogna G, Stirparo S. Techniques for the maintenance of epidural labor analgesia. Curr Opin Anaesthesiol. 2013;26(3):261-267. doi:10.1097/ACO.0b013e328360b069
- (6) Wong CA, McCarthy RJ, Hewlett B. The effect of manipulation of the programmed intermittent bolus time interval and injection volume on total drug use for labor epidural analgesia: a randomized controlled trial. Anesth Analg. 2011;112(4):904-911. doi:10.1213/ANE.0b013e31820e7c2f