Sheetal M. Dalal

ABSTRACT

A journey of labour analgesia has conquered the path from era of chroroform to the present day practice of various revolutionized methods in the management of labouring parturients using evidence based medicine based on ‘Fetomatenal Safety is prime Concern’. Newer Aspects broadly includes introduction of combined spinal epidurals, low dose epidurals facilitating Ambulation, less toxic local anaesthetic like ropivacaine, levobupivacine, less toxic opioids sufentanil, remifentanil, Newer patient controlled inhalational analgesia and sevox using speciallised vaporizer. Technological advances like use of ultrasound to reduce epidural failures, introduction of PCEA & computer integrated drug delivery pumps fulfills maternal satisfaction. Recent randomized controlled trial & Cochrane studies have concluded that association of Backache & increased Caesarian section rate with painless labour is myth. Present day low dose epidurals proven to reduce instrumental delivery and improves maternal & foetal safety.