Neuraxial analgesia in labour – initiation and maintenance techniques

Abstract

Neuraxial analgesia is the gold standard for managing pain during labour. Techniques employed to facilitate labour neuraxial analgesia include the use of an epidural catheter, the combined spinal epidural, the dural puncture epidural, and an intrathecal catheter. The adoption of these techniques for labour analgesia varies across different maternity units. Over time, numerous regimens have been developed for enhancing labour neuraxial analgesia effectiveness while minimizing maternal side effects. Patient-controlled epidural analgesia and programmed intermitted bolus techniques are now the most commonly utilized regimens for maintenance of neuraxial analgesia in the UK. This article explores the commonly used techniques and regimens utilized to initiate and maintain neuraxial analgesia in labour.