Analgésie périmédullaire pour le travail obstétrical en 2015

Regional analgesia for labor and delivery should take into account the new expectations of women: ambulation, mobility, feeling contractions but in painless way. Improvement may involve the epidural mixture and the regimen of administration. At low concentration (< 0.1 %) there is little difference in potency or side effects between the 3 local anesthetics used in labor analgesia. Practical aspects may be the criteria of choice. Opioid adjuvant has a key role in low dose epidural regimens. Clonidine could be the drug of choice to resolve breakthrough pain or perineal pain. The major interest of CSE is the high quality of analgesia it gives for the first hour. PIEB may be a preferable technique to CEI for the maintenance of labor analgesia.