Analgesia during labour: from taboo
to evidence-based medicine
by
Schneider MC.
Anasthesie,
Universitatsfrauenklinik Basel,
Switzerland.
Schneiderma@ubaclu.unibas.ch
Anaesthesist. 2002 Dec;51(12):959-72

ABSTRACT

Peripartum care of parturients has contributed a great deal to the development of modern anaesthesia during the past 150 years. The introduction of general and regional anaesthesia provided new options of relieving pain during delivery and preventing suffering. However,provision of effective labor analgesia gave and still gives rise to controversy as to whether interfering with natural events such as delivery was justifiable on a religious,moral or ideological level. A new era of obstetric pain relief was initiated when a study design was devised to define the Minimum Local Analgesic Concentration (MLAC) needed for epidural analgesia. Using the MLAC model as a scientifically based pharmacodynamic measure of analgesia, empirically developed "recipes" can be compared and validated. The importance of this clinical model will be put into a pharmacological context including issues such as the up-down sequential allocation technique, dose-response curves and differential nerve blockade.

People
Labour pain
Anaesthesia
Adverse effects
Obstetric anaesthesia
Inhalational techniques
Contemporary anaesthesia
Anaesthesia and anaesthetics
Nitrous oxide: adverse effects
Anaesthesia: rivalries and discoveries
Consciousness, anaesthesia and anaesthetics
First use of anaesthetics in different countries
Early religious/military opposition to anaesthetics

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