Labour Analgesia Research Paper

1.0 OVERVIEW

1.1 What is labour analgesia

Labour analgesia is a pain reliever during the stages of labour. Most women require pain relief during labour as the pain that women experience during labour is affected by physiological and psychosocial factors.1 The analgesia will block the psychological and biochemical stress response.2

1.2 What if labour analgesia is not given For those woman who can’t stand the pain may give physiological effect to the maternal.2

Figure 1: The adverse effects of pain in labour on mother3

1.3 Indication 3,4

• Patient request

• Maternal cardiac, cerebrovascular or respiratory disease

• Pre-eclampsia

• Fetus “at risk” e.g. PET

• Breech delivery or multiple pregnancy

• Obese patient or other risk factors for

Continuous epidural infusion provide consistant analgesia and haemodynamic stability besides reduced risk maternal hypotension, improved patient satisfaction and reduced workload for the anesthesiologist.3, 17, 18 From previous study, an advancement has been done towards continuous epidural infusion to avoid possibility of accidental epidural infusion of oxytocics or intravenous infusion of bupivacaine.18 The use of standard intravenous infusion sets with Ivac controllers is no longer been used.18 Instead, they used the Vickers Treonic IP3 infusion pump which is more

Three optical fibers are embedded in Tuohy needle shaft:

1. emits light;

2. absorb light

3. optical spectra are analyzed to identify the various tissue planes

vi) CSEA technique

With the evolution of sequential “needle-through needle” combined spinal epidural technique, it can be safely used to provide labour analgesia.16 The CSEA kit spinal needle is a fine pencil-point needle that comes with a locking device, which minimizes postdural puncture headache and failed spinals. Use of the spinal opioids provides immediate analgesia without producing any motor block thus producing an ambulatory block.26 The epidural catheter is activated with low-dose mixtures of opioid and local anaesthetics; hence, the ability to walk is not impaired.26

vii) Programmable PCA