52. Obstetric Analgesia and Anesthesia

  1. John T. Queenan MD2,
  2. Catherine Y. Spong MD3 and
  3. Charles J. Lockwood MD4
  1. Gilbert J. Grant MD

Published Online: 4 JAN 2012

DOI: 10.1002/9781119963783.ch52

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

How to Cite

Grant, G. J. (2012) Obstetric Analgesia and Anesthesia, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch52

Editor Information

  1. 2

    Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA

  2. 3

    Bethesda, MD, USA

  3. 4

    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Author Information

  1. Department of Anesthesiology, New York University School of Medicine, New York, NY, USA

Publication History

  1. Published Online: 4 JAN 2012
  2. Published Print: 24 FEB 2012

ISBN Information

Print ISBN: 9780470655764

Online ISBN: 9781119963783

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Keywords:

  • obstetric analgesia and anesthesia;
  • obstetric pain relief;
  • labor and vaginal delivery;
  • multimodal regional analgesia;
  • respiratory alkalosis, affecting fetal oxygenation;
  • spinal approach, or a CSE approach;
  • epidural, spinal, combined spinal–epidural analgesia;
  • patient-controlled epidural analgesia;
  • physiologic changes of pregnancy, anesthesia in CD;
  • postoperative analgesia

Summary

Obstetric pain relief has progressed considerably since 1847, when Dr James Young Simpson administered ether to facilitate vaginal delivery for a woman with a deformed pelvis. Analgesics administered by systemic routes (inhalation, intravenous, intramuscular) have been largely supplanted by regional administration of analgesics using the spinal and epidural routes. A distinct advantage of regional analgesia and anesthesia is that profound pain relief may be achieved with relatively low doses of analgesics, preserving maternal alertness and decreasing fetal exposure. Although systemic analgesics remain an option, in the US the regional route is used for the majority of parturients. This chapter describes current practices in obstetric anesthesia.