• Fábio Farias de Aragão, Pedro Wanderley de Aragão, Carlos Alberto Martins, Karlla Fernanda Custódia Silva Leal, and Ferraz Tobias Alexandro A Maternidade Natus Lumine, Serviço de Anestesiologia, São Luís, MA, Brasil..
• Sociedade Brasileira de Anestesiologia, Rio de Janeiro, RJ, Brasil; Universidade Federal do Maranhão (UFMA), Ciências da Saúde, São Luís, MA, Brasil; Maternidade Natus Lumine, Serviço de Anestesiologia, São Luís, MA, Brasil. Electronic address: fabio.aragao30@gmail.com.
• Rev Bras Anestesiol. 2019 May 1; 69 (3): 291-298.

AbstractThe use of analgesia techniques for labor has become increasingly frequent, with neuraxial techniques being the most commonly used and most effective. Labor pain entails a number of physiological consequences that may be negative for the mother and fetus, and therefore must be treated. This literature review was performed through a search in the PubMed database, from July to November 2016, and included articles in English or Portuguese, published between 2011 and 2016 or anteriorly, if relevant to the topic. The techniques were divided into the following topics: induction (epidural, combined epidural-spinal, continuous spinal, and epidural with dural puncture) and maintenance of analgesia (continuous epidural infusion, patient-controlled epidural analgesia, and intermittent epidural bolus). Epidural analgesia does not alter the incidence of cesarean sections or fetal prognosis, and maternal request is a sufficient indication for its initiation. The combined technique has the advantage of a faster onset of analgesia; however, patients are subject to a higher incidence of pruritus resulting from the intrathecal administration of opioids. Patient-controlled analgesia seems to be an excellent technique, reducing the consumption of local anesthetics, the number of anesthesiologist interventions, and increasing maternal satisfaction.Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

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