Abstract
The aim of this study is to comprehensively compare the efficacy of epidural and spinal analgesia in relieving pain during labor in primiparous women. Methodology: To achieve the proposed objective, we conducted a systematic literature review, consulting electronic databases such as PubMed, Scopus, and Web of Science. A combination of search terms was used. Only comparative studies, such as randomized controlled trials and cohort studies, that directly investigated the efficacy of epidural versus spinal analgesia in primiparous women were included. The methodological quality of the selected studies was assessed following specific guidelines and predefined criteria. Results: After a thorough analysis of the included studies, we observed that both epidural and spinal analgesia were effective in relieving pain during labor in primiparous women. However, the results indicated that epidural analgesia may provide more complete and prolonged pain relief, while spinal analgesia tends to have a quicker onset of action. Additionally, both techniques were associated with acceptable rates of complications and adverse effects, although some differences were observed regarding safety profiles. Conclusion: Based on the results obtained, we conclude that both epidural and spinal analgesia are effective options for pain relief during labor in primiparous women. The choice between these techniques should be individualized, taking into consideration patient preferences, progression of labor, and specific characteristics of each technique. A detailed discussion between the patient and the medical team is essential to determine the best analgesic approach for each case.
References
Côrtes CA de F, Sanchez CA, Oliveira AS, Sanchez FM. Analgesia de parto: estudo comparativo entre anestesia combinada raquiperidural versus anestesia peridural contínua. Rev Bras Anestesiol [Internet]. 2007Jan;57(1):39–51. Available from: https://doi.org/10.1590/S0034-70942007000100005
Souza MA de, Silva JLP e, Maia Filho NL. Bloqueio combinado raquiperidural versus bloqueio peridural contínuo para analgesia de parto em primigestas: resultados maternos e perinatais. Rev Bras Ginecol Obstet [Internet]. 2009Oct;31(10):485–91. Available from: https://doi.org/10.1590/S0100-72032009001000003
Orange FA de, Amorim MMR de, Lima L. Uso da eletroestimulação transcutânea para alívio da dor durante o trabalho de parto em uma maternidade-escola: ensaio clínico controlado. Rev Bras Ginecol Obstet [Internet]. 2003Feb;25(1):45–52. Available from: https://doi.org/10.1590/S0100-72032003000100007
Vale NB do, Vale LFB do, Cruz JR. O tempo e a anestesia obstétrica: da cosmologia caótica à cronobiologia. Rev Bras Anestesiol [Internet]. 2009Sep;59(5):624–47. Available from: https://doi.org/10.1590/S0034-70942009000500013
Monteiro JC dos S, Pitangui ACR, Sousa L de, Beleza ACS, Nakano AMS, Gomes FA. Associação entre a analgesia epidural e o trauma perineal no parto vaginal. Esc Anna Nery [Internet]. 2009Jan;13(1):140–4. Available from: https://doi.org/10.1590/S1414-81452009000100019
Imbelloni LE, Beato L. Comparação entre raquianestesia, bloqueio combinado raqui-peridural e raquianestesia contínua para cirurgias de quadril em pacientes idosos: estudo retrospectivo. Rev Bras Anestesiol [Internet]. 2002May;52(3):316–25. Available from: https://doi.org/10.1590/S0034-70942002000300006
Felisbino-Mendes MS, Santos LO, Amorim T, Costa IN, Martins EF. O uso de analgesia farmacológica influencia no desfecho de parto?. Acta paul enferm [Internet]. 2017Sep;30(5):458–65. Available from: https://doi.org/10.1590/1982-0194201700067
Schmidt SRG, Schmidt AP, Schmidt AP. 19 - Anestesia e analgesia de parto. Arq Bras Cardiol [Internet]. 2009Dec;93(6):169–71. Available from: https://doi.org/10.1590/S0066-782X2009001300019
Beleza ACS, Ferreira CHJ, Sousa L de, Nakano AMS. Mensuração e caracterização da dor após episiotomia e sua relação com a limitação de atividades. Rev Bras Enferm [Internet]. 2012Mar;65(2):264–8. Available from: https://doi.org/10.1590/S0034-71672012000200010
Leal M do C, Pereira APE, Domingues RMSM, Filha MMT, Dias MAB, Nakamura-Pereira M, et al.. Intervenções obstétricas durante o trabalho de parto e parto em mulheres brasileiras de risco habitual. Cad Saúde Pública [Internet]. 2014;30:S17–32. Available from: https://doi.org/10.1590/0102-311X00151513
Gomes MEW, Balle VR, Machado SB, Mendes FF. Estudo comparativo entre concentrações de bupivacaína a 0,125% e a 0,25% associada ao fentanil para analgesia de parto por via peridural. Rev Bras Anestesiol [Internet]. 2004Jul;54(4):467–72. Available from: https://doi.org/10.1590/S0034-70942004000400002
Côrtes CAF, Castro LFL, Serafim MM, Oliveira AS, Gelmini M, Petri RB. Estudo comparativo entre bupivacaína racêmica a 0,25% e bupivacaína com excesso enantiomérico de 50% (S75-R25) a 0,25%, associadas ao fentanil para analgesia de parto com deambulação da parturiente. Rev Bras Anestesiol [Internet]. 2006Jan;56(1):16–27. Available from: https://doi.org/10.1590/S0034-70942006000100003
Gallo RBS, Santana LS, Marcolin AC, Ferreira CHJ, Quintana SM. Grau de dilatação cervical e solicitação da analgesia regional por parturientes com membranas corioamnióticas íntegras e rotas. Rev dor [Internet]. 2012Jan;13(1):30–4. Available from: https://doi.org/10.1590/S1806-00132012000100006
Knobel R, Radünz V, Carraro TE. Utilização de estimulação elétrica transcutânea para alívio da dor no trabalho de parto: um modo possível para o cuidado à parturiente. Texto contexto - enferm [Internet]. 2005Apr;14(2):229–36. Available from: https://doi.org/10.1590/S0104-07072005000200010

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2024 Rômulo Henrique da Silva Cardoso , Joyce Araújo Ribeiro coelho , Solange Mendes Vieira , Victoria Wollf Beirith , João Pedro Libório Neiva Eulálio, Kin Alexia da Rocha kudo , Lucas Andrade Fidalgo Cunha , Darlenne Galdino Camilo , Brena Suanne Carvalho Fernandes , Milena Villela Martins , Carolina de Castro Carvalho , Ingrid Paloma machado Vieira , Mariana Delgado Santos Buarque , Thiago Webster Fernandes Farias, Pedro Victor Alves Castro, Mateus ribeiro Vasconcelos Rezende