Pharmacological obstetric analgesia: a study of obstetric and neonatal outcomes

Abstract

Objective: to investigate the association between pharmacological obstetric analgesia and obstetric and neonatal outcomes. Methods: it was a retrospective case-control study conducted with 393 pregnant women comprising 131 cases of pharmacological obstetric analgesia and 262 controls that did not perform this procedure. The sociodemographic and obstetric profile, the circumstances of parturient admission, obstetrical decisions, and obstetric and neonatal outcomes were investigated. Results: pregnant women submitted to pharmacological analgesia during labor presented an increased risk for the use of exogenous oxytocin (p<0.001), episiotomy (p=0.001), Kristeller maneuver (p=0.036), and forceps (p=0.004). Conclusion: pharmacological analgesia does not increase the risk of spontaneous perineal tear, abdominal delivery, and hospitalization in neonatal unit. Nevertheless, it influences the increased risk of synthetic oxytocin use, Kristeller maneuver, episiotomy, forceps, and the occurrence of lower first-minute Apgar scores.

Association between early pregnant hospitalization and use of obstetric interventions and cesarean: a cross-sectional study

“…International studies bring similar findings, and such interventions are statistically related to delivery route (8,(18)(19)(20) . It was also possible to evaluate that parturient women submitted to analgesia during labor present an increased chance of being subjected to oxytocin infusion (21) .…”

Ultrasound-Guided Regional Analgesia for Post-Cesarean Pain

“…The indications for performing this block fall into a very wide range since there is a number of bibliographies in which better analgesic control and a decrease in the requirement of opioid analgesics is reported in the postoperative period in various thoracic and abdominal surgeries. However, to date the administration of intrathecal morphine remains the gold standard for analgesic management for [3,4]. Topics in Regional Anesthesia elective cesarean sections, as recommended in the PROSPECT study [3], where they place regional blocks as an alternative for cases in which there is a contraindication to approach the neuraxis and consequently, the administration of IT morphine or an IT opioid is not available.…”

“…Based on the foregoing, multimodal analgesic management seeks to minimize the undesirable effects on the mother-newborn binomial in order to increase maternal satisfaction and that the relationship between the mother and her newborn is not altered, since the regional analgesia techniques have gained territory by reducing the consumption of analgesics in the immediate postoperative period, and also are easy to perform procedures. Among the most studied we will review the more important aspects of the abdomen transverse plane (TAP), quadratus lumborum and erectus spinae plane blocks [1][2][3][4][5][6][7].…”

Analgesia obstétrica utilizando a técnica de bloqueio paravertebral torácico bilateral: Relato de experiência em uma maternidade de risco habitual

“…Após discussão com obstetra, pediatra e enfermeira, optou-se pela tentativa de manutenção do trabalho de parto com analgesia obstétrica (devido à fobia à dor do parto da parturiente), com intuito de não converter o parto normal à cesariana por exclusiva razão de dor da paciente. Entende-se que o medo à dor é um dos fatores que contribui com o aumento nos índices de cesarianas no Brasil (Fernandes et al, 2017).…”