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Analgésie obstétricale et efforts expulsifs

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42es Journées nationales de la Société Française de Médecine Périnatale (Montpellier 17–19 octobre 2012)

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Résumé

L’analgésie périmédullaire est la principale modalité d’analgésie obstétricale. Elle est utilisée dans environ 70 % des accouchements en France, pour le confort maternel et la sécurité qu’elle offre. L’impact de l’analgésie périmédullaire sur les efforts expulsifs est, la plupart du temps, évalué par le biais de la durée du deuxième stade du travail et de la fréquence des extractions instrumentales (ou la fréquence des expulsions spontanées). Les résultats des études consacrées aux impacts de l’analgésie périmédullaire sur les paramètres du travail et sur les modalités de l’accouchement sont variables, traduisant les évolutions du matériel (cathéters multiperforés) et de la pratique anesthésique (solutions diluées d’anesthésiques locaux, utilisations d’adjuvants, mode PCEA...). L’analgésie périmédullaire influence peu le travail, en particulier la phase d’expulsion. Son utilisation s’accompagne d’un allongement d’environ 15 min de la durée du 2e stade du travail. Avec les modalités actuelles de pratique de l’analgésie péridurale obstétricale, il n’existe pas d’évidence pour une augmentation du risque d’extraction instrumentale.

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  1. Département anesthésie-douleur, GHU Caremeau, Place du Pr Debré, 30029, Nîmes Cedex 09, France

    G. Aya

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Aya, G. (2013). Analgésie obstétricale et efforts expulsifs. In: 42es Journées nationales de la Société Française de Médecine Périnatale (Montpellier 17–19 octobre 2012). Springer, Paris. https://doi.org/10.1007/978-2-8178-0385-2_13

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  • DOI: https://doi.org/10.1007/978-2-8178-0385-2_13

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0384-5

  • Online ISBN: 978-2-8178-0385-2

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