Analgesia and anaesthesia in labour

Analgesia is often required in labour for both humanitarian and medical reasons. Although many techniques are used to provide analgesia in labour, neuraxial (epidural or intrathecal) analgesia is the only technique capable of producing complete pain relief. The use of analgesia in labour is influenced by parity, duration of labour, experience in a previous labour and the induction as opposed to the spontaneous onset of labour. Modern epidural techniques aim to achieve pain relief without compromising motor function and the ability to push in the second stage. This is achieved by using low concentrations of local anaesthetic (bupivacaine 0.065-0.10%) and opioid solutions. Maternal mortality associated with anaesthesia has fallen dramatically in the past 50 years consequent to the increased use of regional anaesthesia for obstetric surgery, together with the more focused training of anaesthetists.