Local anaesthetic nerve block for pain management in labour

Novikova, Natalia; Cluver, Catherine

doi:10.1002/14651858.cd009200

Cited by 29 publications

(11 citation statements)

References 13 publications

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“…The ideal anesthetics should exhibit features such as rapid and reliable anesthetic effects with minimal to no toxicity. Chloroprocaine has been widely used in infiltration anesthesia and nerve block worldwide, 8,9 and is especially applicable to outpatient procedures and daytime surgeries. 1,4,10 In particular, chloroprocaine was used for epidural block and subarachnoid space block.…”

Section: Discussionmentioning

confidence: 99%

Comparison of epidural anesthesia with chloroprocaine and lidocaine for outpatient knee arthroscopy

Yang

Zhang

et al. 2019

J Orthop Surg (Hong Kong)

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This study aimed to compare clinical efficacy and safety of chloroprocaine and lidocaine in epidural anesthesia for outpatient knee arthroscopy. Eighty patients undergoing knee arthroscopy were randomly allocated to receive 3% 2-chloroprocaine (group C, n = 40) or 2% lidocaine (group L, n = 40) for epidural block. Latency to anesthesia onset, highest block level, time to achieve peak effect, time to complete sensory and motor block regression, vital signs including respiration and hemodynamics, and complications during follow-up were recorded. No significant differences were found in the latency to anesthesia onset and peak effect, duration of anesthesia efficacy, and the time for recovery of sensory function between the two groups. However, the latency to maximal block of pain sensation and the time needed to recover motor function were significantly shorter in group C than in group L ( p < 0.05). No adverse effects or neurologic complications were found in both groups. In conclusion, epidural chloroprocaine elicits rapid anesthetic effects, fast sensor and motor block, and faster recovery of motor function compared to lidocaine. These characteristics make chloroprocaine better than lidocaine as the choice of epidural anesthesia in short clinical operations such as knee arthroscopy.

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Section: Discussionmentioning

confidence: 99%

Comparison of epidural anesthesia with chloroprocaine and lidocaine for outpatient knee arthroscopy

Yang

Zhang

et al. 2019

J Orthop Surg (Hong Kong)

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“…Current recommendations for pain management emphasise the importance of prophylactic and multimodal methods (10,32), which many of the guidelines included in the recommendations. Epidural analgesia and paracervical block, which are common and effective interventions for obstetric pain (33,34), were recommended in a proportion of the guidelines. However, its place in the pain management of patients undergoing medically induced abortion has been questioned (3,35), and few patients are administered these alternatives in clinical practice (36).…”

Section: Discussionmentioning

confidence: 99%

Management of physical pain during induced second‐trimester medical abortions: a cross‐sectional study of methodological quality and recommendations in local clinical practice guidelines at Swedish hospitals

Carlsson

2018

Scandinavian Caring Sciences

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The findings indicate that local clinical practice guidelines about induced second-trimester medical abortions are of inadequate methodological quality and that a large majority lack recommendations concerning systematic pain measurements. Although most recommend prophylactic and as needed pharmacologic management, national inconsistencies exist in Sweden with regard to recommendations of epidural analgesia, nitrous oxide and nonpharmacologic methods. In Sweden, there is room for improvement in the development of these guidelines.

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“…Cochrane reviews reported that local anesthetic nerve blocks, including pudendal block, and paracervical block, were more effective than placebo, opioids, and non-opioids for pain management in labor. 9 Most of the articles available in the literature discuss labor analgesia in whole labor and that too with epidural analgesia. Studies by Mousa et al and Fan et al, where epidural analgesia was used for pain relief in labor, found decreasing trend in pain score throughout the labor including the second stage.…”

Section: Discussionmentioning

confidence: 99%

Quest for Labor Analgesia in Second Stage in Resource Poor Setup

Das¹,

Khatuja²,

Mittal³

2018

Journal of South Asian Federation of Obstetrics and Gynaecology

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194Aim: To assess the analgesic effect of pudendal nerve block (PNB) as labor analgesia in the second stage of labor, its effect on the duration of the second stage and to assess any adverse maternal and fetal outcome. Materials and methods:The prospective, randomized, casecontrol study (parallel group trial) was conducted with a total of 110 parturient women. They were randomly allocated to either study group (n = 55) or control group (n = 55). The study was performed after the approval of the institutional ethical committee. All the women recruited for the study were given first stage analgesia. The pain was assessed using the verbal rating scale. In the second stage of labor, the women in the study group were given transvaginal PNB (5 mL of 1% Lignocaine + 5 mL of 0.25% bupivacaine) bilaterally, whereas, in control group, no added analgesia was given. Statistical analysis:Quantitative data were compared using the unpaired t-test and qualitative data was compared using chi square test. p ≤ 0.05 has been taken as the level of statistical significance. The data were analyzed by Statistical Package for the Social Sciences (SPSS) statistical software version 17.0.Results: It was observed that in the second stage of labor, Pudendal Nerve Block produced pain relief in 98.2% women, out of which 14.6% had excellent pain relief and 52.7% had moderate pain relief. This was found to be statistically significant (p < 0.05). The mean duration of the second stage of labor was longer in the study group (29.02 minutes) than in the control group (16.86 minutes) (p < 0.05). There was no significant adverse maternal and fetal outcome. Conclusion:The PNB provides an effective analgesia in the second stage of labor without the major neonatal and maternal morbidity.Clinical significance: The PNB can be provided by obstetricians in any delivery setup, even in low resource settings, without the need for skilled anesthetists.

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Local anaesthetic nerve block for pain management in labour

Cited by 29 publications

References 13 publications

Comparison of epidural anesthesia with chloroprocaine and lidocaine for outpatient knee arthroscopy

Comparison of epidural anesthesia with chloroprocaine and lidocaine for outpatient knee arthroscopy

Management of physical pain during induced second‐trimester medical abortions: a cross‐sectional study of methodological quality and recommendations in local clinical practice guidelines at Swedish hospitals

Quest for Labor Analgesia in Second Stage in Resource Poor Setup

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