Update on Non-neuraxial Labor Analgesia

Abstract

Purpose of review: This review will present recent updates for the use of non-neuraxial analgesia for laboring women.

Recent findings: Non-neuraxial labor analgesia by nitrous oxide and intravenous opioids are described, and safety concerns with regard to remifentanil administration have been a major focus of recent studies. Fentanyl and nitrous oxide offer some efficacy, albeit less than remifentanil, however with a greater safety margin.

Summary: Women may request or require alternatives to neuraxial labor analgesia, in some cases due to concurrent comorbidities. Remifentanil offers the most efficacious alternative analgesia option; however, safety concerns may preclude widespread use.

Keywords: Analgesia; Epidural; Labor; Non-neuraxial; Remifentanil; Safety.