Dr. Kwok-Key LAM
Clinical Associate Professor, Department of Anaesthesiology, The University of Hong Kong, Hong Kong
Honorary Consultant, Department of Anaesthesiology, Queen Mary Hospital, Hong Kong
Over the past decade, the availability of safer local anaesthetics, ultra-short acting opioids, combined spinal-epidural needles, patient-controlled analgesic devices, and ultrasound have revolutionised obstetric regional analgesia. In the symposium, the most recent evidence on the efficacy and safety of the various pain-relieving techniques are reviewed. Recent meta-analyses have supported epidural analgesia as the most efficacious technique, as it leads to higher maternal satisfaction and good maternal and fetal safety profiles. Recent evidence also favours the use of mixture of low concentration local anaesthetic and lipophilic opioids as its minimal impact on the rates of instrumental and operative delivery. The controversies and myths concerning the initiation, maintenance, and discontinuation of epidural analgesia are examined. New developments in labour analgesia such as intravenous patient-controlled remifentanil and suba-nesthetic doses of sevoflurane are also discussed.