Document Detail


Epidural analgesia for pain relief in labour and childbirth - a review with a systematic approach.
MedLine Citation:
PMID:  15086632     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinical ambiguity concerning effects of epidural analgesia for pain relief in labour seems to reflect a need for evidence-based knowledge for midwives. AIMS: This study aimed to review, with a systematic approach, the literature about effects and risks associated with the use of epidural analgesia for pain relief in labour and childbirth. DESIGN: A structured question was formulated and used for deriving search terms, establishing the inclusion of certain criteria and retrieving articles, i.e. what are the effects of epidural analgesia for pain relief in labour and childbirth? References were obtained through searches using MeSH-terms in Medline and Subheadings (SH) in CINAHL (e.g. Obstetrical Analgesia combined either with psychology or adverse effects and together with, Dystocia, Caesarean Section, Infant Newborn and Breastfeeding). The articles were divided into prospective randomized trials (C), non-randomized prospective studies (P) and retrospective studies (R). Scientific quality of the studies was assessed on a three-grade scale: high scientific quality (I), moderate scientific quality (II) or low scientific quality (III). RESULTS: Twenty-four articles were retrieved and systematically assessed. Seven studies were judged as high quality, 15 as moderate quality and two as low quality. The majority of studies appraised in this review failed to obtain or establish a cause and effect relationship. According to the data, it seems clear that the use of epidural analgesia is considered to be an effective method of pain relief during labour and childbirth from the perspective of women giving birth. RELEVANCE TO CLINICAL PRACTICE: Midwives and doctors can recommend this form of pain relief. However, information about possible associations with adverse effects in mothers and infants must be provided to expectant couples.
Authors:
Astrid Nystedt; David Edvardsson; Ania Willman
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of clinical nursing     Volume:  13     ISSN:  0962-1067     ISO Abbreviation:  J Clin Nurs     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-16     Completed Date:  2004-06-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9207302     Medline TA:  J Clin Nurs     Country:  England    
Other Details:
Languages:  eng     Pagination:  455-66     Citation Subset:  N    
Affiliation:
Obstetrics and Gynaecology, Department of Clinical Science, Umeå University, Umeå, Sweden. astrid.nystedt@nurs.umu.se
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MeSH Terms
Descriptor/Qualifier:
Analgesia, Epidural* / adverse effects,  nursing,  psychology,  standards
Analgesia, Obstetrical* / adverse effects,  nursing,  psychology,  standards
Attitude to Health
Breast Feeding
Cesarean Section
Evidence-Based Medicine
Female
Humans
Multicenter Studies as Topic
Nurse Midwives / standards
Obstetric Labor Complications / diagnosis,  drug therapy*,  psychology
Obstetrical Nursing / standards
Pain / diagnosis,  drug therapy*,  psychology
Pain Measurement
Pregnancy
Prospective Studies
Randomized Controlled Trials as Topic
Research Design / standards
Retrospective Studies
Risk Factors
Treatment Outcome
Comments/Corrections
Comment In:
J Clin Nurs. 2004 Sep;13(6):779-81   [PMID:  15317524 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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