![]() Overall, women using epidural analgesia may be more likely to require forceps or ventouse to assist with the birth when compared with opioid drugs. Epidurals may relieve labour pain more effectively than opioids, and more women may be more satisfied with epidural as pain relief. The trials varied in the quality of their methods.Īll but six studies compared epidural analgesia with injected opioid drugs. ![]() We searched for evidence in April 2017 and identified 40 trials, involving over 11,000 women, that contributed information to this review. Rare but potentially severe adverse effects of epidural analgesia can occur, such as severe long-lasting headache after the injection, or nerve injury. Side effects such as itchiness, drowsiness, shivering and fever have been reported. Combined-spinal-epidural involves a single injection of local anaesthetic or opiate into the cerebral spinal fluid for fast onset of pain relief, as well as insertion of the epidural catheter for continuing pain relief. Lower concentrations of local anaesthetic when given together with an opiate allow women to maintain the ability to move around during labour and to actively participate in the birth. Epidural solutions are given by bolus injection (a large, rapid injection), continuous infusion or using a patient-controlled pump. Epidurals are widely used for pain relief in labour and involve an injection of a local anaesthetic into the lower region of the back close to the nerves that transmit pain. Pharmacological methods of pain relief include breathing in of nitrous oxide, injection of opioids and local analgesia with an epidural for a central nerve block. Pain relief is important for women in labour. We set out to assess the effectiveness of all kinds of epidural analgesia (including combined-spinal-epidural) on the mother and the baby, when compared with non-epidural or no pain relief during labour.
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