Long-term effects of neuraxial analgesia

Kearns, R.J. , Broom, M.A. and Lucas, D.N. (2024) Long-term effects of neuraxial analgesia. Current Opinion in Anaesthesiology, (doi: 10.1097/ACO.0000000000001365) (PMID:38390906) (Early Online Publication)

Abstract

Purpose of review: This review article explores the potential longer-term implications of neuraxial analgesia in labour for both the mother and her child. Recent findings: Neuraxial techniques for labour analgesia are well tolerated and effective, and long-term adverse sequelae are rare. Labour epidural analgesia is not independently associated with long-term headache, backache, postnatal depression or anal sphincter injury, and evidence supports that epidurals may offer protection against severe maternal morbidity, particularly in women at a higher risk of complications. However, there is an increasing awareness that postdural puncture headache may be associated with chronic headache, back pain and postnatal depression, emphasizing the need for adequate follow-up until symptoms resolve. For the neonate, a growing body of evidence refutes any association between epidural analgesia in labour and the later development of autism spectrum disorder. The clinical significance of epidural related maternal fever remains uncertain and is a research priority. Summary: Women should continue to access the significant benefits of neuraxial analgesia in labour without undue concern about adverse sequelae for themselves or their offspring. Measures to prevent, appropriately manage and adequately follow-up women who have suffered complications of neuraxial analgesia, such as postdural puncture headache, are good practice and can mitigate the development of long-term sequelae.

• Item Type: Articles
• Additional Information: This work was supported by NHS Research Scotland Career Researcher Fellowship (RK).
• Keywords: Neuraxial analgesia, epidural, post-dural puncture headache, autism spectrum disorder, epidural related maternal fever.
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Broom, Dr Malcolm and Kearns, Dr Rachel
• Authors: Kearns, R.J., Broom, M.A., and Lucas, D.N.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Current Opinion in Anaesthesiology
• Publisher: Lippincott, Williams & Wilkins
• ISSN: 0952-7907
• ISSN (Online): 1473-6500
• Published Online: 22 February 2024
• Copyright Holders: Copyright © 2024 Wolters Kluwer Health, Inc.
• First Published: First published in Current Opinion in Anaesthesiology 2024
• Publisher Policy: Reproduced in accordance with the publisher copyright policy