What is labor analgesia?

Labor analgesia refers to the use of a series of methods to help pregnant women reduce pain during delivery. At present, the most widely used method in clinical practice is to use the method of continuous epidural block analgesia, that is, puncture the waist to the epidural space and place a very soft thin tube, which is connected with the patient-controlled analgesia pump with low concentration local anesthetic drugs, so as to block the sensory nerve of pain conduction through drugs during the labor of uterine contraction, so as to relieve the pain without affecting the movement and uterine contraction. Labor analgesia helps to alleviate the pain of parturient women in the process of delivery, alleviate the tension / anxiety of parturient women, and make childbirth more humanized.

Advantages of labor analgesia?

Strong uterine contraction pain will lead to increased secretion of catecholamines in pregnant women, affect the oxygen supply of placenta and increase the risk of fetal hypoxia. Pain during delivery is also an important risk factor for postpartum depression. Therefore, labor analgesia can not only improve maternal comfort and reduce pain, but also ensure the safety of mothers and infants and reduce the incidence of postpartum depression. In the process of delivery, pregnant women can also get a good rest and better cooperate with doctors in the process of delivery.

Will labor analgesia affect pregnant women and babies?

The implementation of labor analgesia is based on maintaining the safety of mother and fetus. The concentration of drugs used for labor analgesia is far lower than that required for cesarean section anesthesia. The amount of drugs absorbed through the placenta is very small and will not have adverse effects on the fetus. Due to the normal physiological curvature of the spine during pregnancy and delivery and the changes of hormones, 40% of normal postpartum mothers will have low back pain, which has nothing to do with whether to carry out labor analgesia. Epidural block has a certain probability to produce puncture related symptoms of leg numbness, low back pain, headache and urinary retention, most of which can be recovered in a period of time after delivery.

Indications for labor analgesia?

① Maternal voluntary

② Evaluated by obstetricians, vaginal delivery trial can be carried out (including scar uterus, pregnancy induced hypertension and preeclampsia, etc.)

③ No anesthesia related contraindications (including intracranial hypertension, abnormal coagulation function, puncture site and systemic infection, spinal disease or serious spinal deformity, maternal inability to cooperate with puncture, etc.)

When can it be implemented?

According to the traditional concept, when the uterine orifice is opened to 3cm, at present, a large number of clinical studies and meta-analysis have shown that the onset of intraspinal analgesia in the incubation period does not increase the cesarean section rate or prolong the first stage of labor, so the size of maternal uterine orifice is no longer used as the starting time of labor analgesia. When the labor process is determined to start, the uterus shrinks regularly, and the parturient feels a certain degree of pain. If there is a need for analgesia, it can be implemented.

In this paper, Wang Tao, chairman of the medical science popularization special committee of the China Science Popularization Writers Association, conducted a scientific check.

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