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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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https://afar.info/id=2978

Created on : 12 Jul 2018
Modified on : 25 Jul 2018

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Bibliographical entry (without author) :

Epidurals for pain relief in labour. 2018 Cochrane

Author(s) :

Anim-Somuah M, Smyth RMD, Cyna AM, Cuthbert A

Year of publication :

2018

URL(s) :

http://www.cochrane.org/CD000331/PREG_epidurals-pa…

Résumé (français)  :

Des preuves de faible qualité montrent que l’analgésie péridurale peut être plus efficace pour réduire la douleur pendant le travail et augmenter la satisfaction maternelle à l’égard du soulagement de la douleur que les méthodes non épidurales. Bien que les femmes ayant une analgésie péridurale aient eu un risque augmenté d’extraction instrumentale, une analyse post hoc a montré que cet effet n’est pas observé dans les études récentes (après 2005), ce qui suggère que les approches modernes de l’analgésie péridurale au travail n’affectent plus cet effet. résultat. L’analgésie péridurale n’a eu aucun impact sur le risque de césarienne ou de mal de dos à long terme et n’a pas semblé avoir un effet immédiat sur le statut néonatal tel que déterminé par les scores Apgar ou les admissions en soins intensifs néonatals. Des recherches plus approfondies pourraient être utiles pour évaluer les effets indésirables rares mais potentiellement graves de l’analgésie péridurale et de l’analgésie non péridurale chez les femmes au travail et les résultats néonatals à long terme.

Abstract (English)  :

Low-quality evidence shows that epidural analgesia may be more effective in reducing pain during labour and increasing maternal satisfaction with pain relief than non-epidural methods. Although overall there appears to be an increase in assisted vaginal birth when women have epidural analgesia, a post hoc subgroup analysis showed this effect is not seen in recent studies (after 2005), suggesting that modern approaches to epidural analgesia in labour do not affect this outcome. Epidural analgesia had no impact on the risk of caesarean section or long-term backache, and did not appear to have an immediate effect on neonatal status as determined by Apgar scores or in admissions to neonatal intensive care. Further research may be helpful to evaluate rare but potentially severe adverse effects of epidural analgesia and non-epidural analgesia on women in labour and long-term neonatal outcomes.

Sumário (português)  :

Evidências de baixa qualidade mostram que a analgesia peridural pode ser mais eficaz na redução da dor durante o trabalho de parto e aumentar a satisfação materna com o alívio da dor do que os métodos não-epidurais. Embora no geral pareça haver um aumento no parto vaginal assistido quando as mulheres têm analgesia epidural, uma análise post hoc de subgrupo mostrou que esse efeito não é visto em estudos recentes (após 2005), sugerindo que as abordagens modernas à analgesia peridural no trabalho de parto não afetam resultado. A analgesia peridural não teve impacto no risco de cesárea ou de dor nas costas a longo prazo, e não pareceu ter um efeito imediato sobre o estado neonatal, conforme determinado pelos escores de Apgar ou nas internações em terapia intensiva neonatal. Outras pesquisas podem ser úteis para avaliar os efeitos adversos raros, mas potencialmente graves, da analgesia peridural e da analgesia não epidural em mulheres em trabalho de parto e nos resultados neonatais a longo prazo.

Comments :

Argument (français) :

Des preuves de faible qualité montrent que l’analgésie péridurale peut être plus efficace pour réduire la douleur pendant le travail et augmenter la satisfaction maternelle à l’égard du soulagement de la douleur que les méthodes non épidurales.

Argument (English):

Low-quality evidence shows that epidural analgesia may be more effective in reducing pain during labour and increasing maternal satisfaction with pain relief than non-epidural methods.

Argumento (português):

Evidências de baixa qualidade mostram que a analgesia peridural pode ser mais eficaz na redução da dor durante o trabalho de parto e aumentar a satisfação materna com o alívio da dor do que os métodos não-epidurais.

Keywords :

➡ c-section/caesarean ; pain ; instrumental delivery ; forceps delivery ; vacuum extraction (ventouse)

Author of this record :

Alison Passieux — 12 Jul 2018
➡ latest update : Bernard Bel — 25 Jul 2018

Discussion (display only in English)
12 Jul 2018 13:31[FR] nécessite de revoir les taux d’extractions car il serait surprenant qu’ils aient diminués dans les faits...
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Alison Passieux
 
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