Zusammenfassung
Neuroaxiale Verfahren stellen eine Möglichkeit der Analgesie in der Geburtshilfe dar.
Insbesondere in der späten Phase der vaginalen Entbindung erfordern überraschende
Momente, instrumentelle Methoden oder spezielle Manöver eine schnelle und suffiziente
Analgesie. Hier können die Vorteile der Spinalanästhesie gegenüber der Epiduralanästhesie
clever genutzt werden.
Abstract
Neuroaxial procedures are among the most effective ways of relieving pain during childbirth.
Especially in the late phase of vaginal delivery, surprising moments, instrumental
methods or special maneuvers require quick and sufficient analgesia. This refers to
situations with a sudden, often unexpected and particularly pronounced intensity of
pain. Here the advantages of spinal analgesia over the gold standard of obstetric
analgesia, catheter epidural analgesia, can be used. Spinal analgesia is characterized
by a fast onset of pain relief, a profound blockage and simple technical feasibility
and, like other neuroaxial procedures, is comparatively uncomplicated in pregnant
women. However, it is only effective if the delivery situation is well assessed. There
is no possibility of repetition without re-puncture, so that limited duration of action
is a significant disadvantage. Applied drugs correspond to those described for combined
spinal and epidural analgesia, such as a
mixture of low-dose bupivacaine and sufentanil, and can be adapted to local conditions.
In the future, longer acting substances could overcome the main limitation (temporary
effect) of spinal analgesia and suitable adjuvants could further increase the attractiveness
of the procedure.
Schlüsselwörter
Spinalanalgesie - vaginale Geburt - neuroaxiale geburtshilfliche Analgesie
Key words
spinal analgesia - vaginal delivery - neuroaxial labor analgesia
