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|Al – baha University , KSA|
|Keynote: Gynecol Obstet|
|The pain that women experience during labor is affected by multiple physiological and psychosocial factors and its intensity can vary greatly. Most women in labor require pain relief. We aim to summarize the evidence from Cochrane systematic reviews on the efficacy and safety of non-pharmacological and pharmacological interventions to manage pain in labor. We identified 15 Cochrane reviews (255 included trials) and three non-Cochrane reviews (55 included trials) for inclusion within this overview. Evidence suggests that epidural, combined spinal epidural (CSE) and inhaled analgesia effectively manage pain in labor, but may give rise to adverse effects. Epidural and inhaled analgesia effectively relieve pain when compared with placebo or a different type of intervention. Combined-spinal epidurals relieve pain more quickly than traditional or low dose epidurals. Women receiving inhaled analgesia were more likely to experience vomiting, nausea and dizziness. When compared with placebo or opioid, women receiving epidural analgesia had more instrumental vaginal births and caesarean sections for fetal distress, although there was no difference in the rates of caesarean section overall. There is some evidence to suggest that immersion in water, relaxation, acupuncture, massage and local anesthetic nerve blocks or non-opioid drugs may improve management of labor pain, with few adverse effects. There is insufficient evidence to make judgments on whether or not hypnosis, biofeedback, sterile water injection, aromatherapy, TENS, or parenteral opioids are more effective than placebo or other interventions for pain management in labor. In comparison with other opioids more women receiving pethidine experienced adverse effects including drowsiness and nausea. On conclusion, epidural analgesia provides effective pain relief but at the cost of increased instrumental vaginal birth.|
Mohammad Othman is an Assistant Professor of Obstetrics and Gynecology in University of Al-Baha, College of Medicine, Saudi Arabia. He finished his Bachelor degree in Medicine and Surgery from King Abdulaziz University, Jeddah, Saudi Arabia. He has completed his PhD from University of Liverpool, United Kingdom. He has published three books and more than 52 papers in reputed journals and has been serving as an Editor and referee of more than 32 medical publications and databases.
Email: [email protected]
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